Compositions for Diagnosis and Treatment of Type 2 Diabetes

ABSTRACT

Compositions including an odd chain fatty acid, and salts and derivatives thereof, and methods for metabolic syndrome treatment and prophylaxis are provided, including compositions and methods for treating diabetes, obesity, hyperferritinemia, elevated insulin, glucose intolerance, dyslipidemia and related conditions. Methods for the diagnosis and monitoring of metabolic syndrome are also provided.

INCORPORATION BY REFERENCE TO RELATED APPLICATIONS

Any and all priority claims identified in the Application Data Sheet, orany correction thereto, are hereby incorporated by reference under 37CFR 1.57. This application is a divisional application of U.S.application Ser. No. 15/582,433, which is further a continuationapplication of U.S. application Ser. No. 15/030,031, which is thenational phase under 35 U.S.C. § 371 of prior PCT InternationalApplication No. PCT/US2015/067172, which has an International FilingDate of Dec. 21, 2015, which designates the United States of America,and which further claims priority to U.S. application Ser. No.14/591,660, filed Jan. 7, 2015. Each of the aforementioned applicationsare incorporated by reference herein in their entirety, and are herebyexpressly made a part of this specification.

STATEMENT REGARDING FEDERALLY SPONSORED R&D

The United States Government has ownership rights in this invention,pursuant to passing of title to a Subject Invention under Federal GrantN00014-12-1-0294 (National Marine Mammal Foundation).

FIELD OF THE INVENTION

Compositions including an odd chain fatty acid, and salts andderivatives thereof, and methods for metabolic syndrome treatment andprophylaxis are provided, including compositions and methods fortreating diabetes, obesity, hyperferritinemia, elevated insulin, glucoseintolerance, dyslipidemia and related conditions. Methods for thediagnosis and monitoring of metabolic syndrome are also provided.

BACKGROUND OF THE INVENTION

Metabolic syndrome is an underlying disorder of energy utilization andstorage. Metabolic syndrome affects a substantial proportion of thepopulation of developed countries, including the United States. It isassociated with the risk of developing cardiovascular disease, diabetes(especially type 2 diabetes), and other conditions such as polycysticovary syndrome, fatty liver disease, cholesterol gallstones, asthma,sleep disturbances, and some forms of cancer. Metabolic syndrome ischaracterized by abdominal (central) obesity, elevated blood pressure,elevated insulin, elevated fasting plasma glucose, elevated serumtriglycerides, decreased high-density lipoprotein (HDL) levels,proinflammatory state (recognized clinically by elevations of C-reactiveprotein (CRP)), and a prothrombotic state.

High serum ferritin that is not associated with known genetic mutationshas been observed. Ferritin is a measure of total iron body stores. Highferritin in the blood (i.e., hyperferritinemia) and associated ironoverload have been associated with metabolic syndrome and relateddisorders in humans. Metabolic syndrome is also correlated withhyperferritinemia (with or without iron overload), which is itselfassociated with impaired adiponectin production. Until now, serumferritin has not been routinely tested in human subjects. The mechanismby which high ferritin levels increase the risk of diabetes is not fullyunderstood, but proposed mechanisms include direct injury to the liverand pancreas from excessive deposition or indirect injury from increasedoxidative radicals.

Metabolic syndrome is alternatively known as Syndrome X, prediabetes,cardiometabolic syndrome, insulin resistance syndrome, Reaven'ssyndrome, and CHAOS. A number of risk factors for metabolic syndromehave been identified, which include but are not limited to obesity,advancing age, high stress, and poor diet. Metabolic syndrome can alsoarise due to genetic disorders or other in-born errors of metabolism.

Treatment of metabolic syndrome generally targets the indices namedabove. Often treatment focuses on conditions associated with moreadvanced stages of metabolic syndrome, such as cardiovascular diseaseand diabetes. For diabetes, administration of metformin, insulin, or aninsulin analog is sometimes indicated, as is administration of othermedicaments such as statins, fibrates, and niacin. However, thesemedicaments may lead to undesirable side effects. Early stage treatmentand prevention of metabolic syndrome is generally limited torecommendation of a low saturated fat diet with increased dailyexercise. Some subjects are unable to effectively comply with, orunresponsive to, these regimens.

SUMMARY OF THE INVENTION

Compositions and methods for treatment and prevention of metabolicsyndrome, and treating associated conditions are provided. Thesecompositions comprise one or more odd chain fatty acids, derivatives ofodd chain fatty acids, and salts thereof, which may be administered incombination with other medicaments or as part of various treatmentregimens. The provided compositions are effective for modulating markersassociated with metabolic syndrome, serum hyperferritinemia, elevatedinsulin, glucose intolerance, dyslipidemia and fatty liver. Methods areprovided for administering the compositions.

Accordingly, in a generally applicable first aspect (i.e., independentlycombinable with any of the aspects or embodiments identified herein), apharmaceutical composition is provided, comprising: one or more oddchain fatty acids or pharmaceutically acceptable salts thereof; and apharmaceutically acceptable carrier.

In an embodiment of the first aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), the one ormore odd chain fatty acids is heptadecanoic acid.

In an embodiment of the first aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thecomposition is substantially free from even chain fatty acids.

In an embodiment of the first aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thecomposition comprises a plurality of odd chain fatty acids.

In an embodiment of the first aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thecomposition is in a unit dosage form.

In an embodiment of the first aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thepharmaceutical composition is configured for administration of from 2.5mg to 11 mg, per 1 kg of body weight, of the one or more odd chain fattyacids or pharmaceutically acceptable salts thereof to a patient.

In an embodiment of the first aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thepharmaceutical composition is configured for administration once perday.

In an embodiment of the first aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thepharmaceutical composition comprises from 0.01 mg to 10000 mg of the oneor more odd chain fatty acids or pharmaceutically acceptable saltsthereof.

In a generally applicable second aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), use isprovided of a pharmaceutical composition of the first aspect or any ofits embodiments, in the manufacture of a medicament for treatment orprophylaxis of metabolic syndrome, cardiovascular disease, diabetes,type 2 diabetes, polycystic ovary syndrome, fatty liver, cholesterolgallstones, asthma, sleep disturbance, cancer, abdominal obesity,elevated blood pressure, elevated fasting plasma glucose, elevated serumtriglycerides, decreased high-density lipoprotein levels,proinflammatory state, elevation of C-reactive protein, a prothromboticstate, hyperferritinemia, hyperferritinemia with iron overload, andhyperferritinemia without iron overload.

In an embodiment of the second aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), the use is inthe manufacture of a medicament for treatment or prophylaxis ofhyperferritinemia.

In an embodiment of the second aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), the use is inthe manufacture of a medicament for treatment or prophylaxis ofmetabolic syndrome.

In an embodiment of the second aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thepharmaceutical composition is configured to modulate a marker ofmetabolic syndrome or a symptom of metabolic syndrome. The, marker ofmetabolic syndrome can optionally be selected from the group consistingof odd chain fatty acid percentage, serum concentration of an odd chainfatty acid, red blood cell membrane concentration of an odd chain fattyacid, serum total odd chain fatty acids, red blood cell membrane totalodd chain fatty acids, serum ferritin, serum iron, transferritinsaturation, serum glucose, serum triglycerides, blood pressure,adiponectin, HDL cholesterol, urine microalbumin, CRP, IL-6, TNFα, c-JunN-terminal kinase, ATM and monocyte-chemoattractant protein-1.

In an embodiment of the second aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thepharmaceutical composition is configured to increase a serumconcentration or a red blood cell membrane concentration of the one ormore odd chain fatty acids by at least about 0.01×10⁻⁴ M above apretreatment value.

In a generally applicable third aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), a method isprovided for the treatment or prophylaxis of metabolic syndrome,cardiovascular disease, diabetes, type 2 diabetes, polycystic ovarysyndrome, fatty liver, cholesterol gallstones, asthma, sleepdisturbance, cancer, abdominal obesity, elevated blood pressure,elevated fasting plasma glucose, elevated serum triglycerides, decreasedhigh-density lipoprotein levels, proinflammatory state, elevation ofC-reactive protein, a prothrombotic state, hyperferritinemia,hyperferritinemia with iron overload, and hyperferritinemia without ironoverload, comprising: administering to a patient in need thereof, aneffective amount of one or more odd chain fatty acids orpharmaceutically acceptable salts thereof.

In an embodiment of the third aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), the one ormore odd chain fatty acids or pharmaceutically acceptable salts thereofis provided as a pharmaceutical composition in a unit dosage formcomprising the one or more odd chain fatty acids or pharmaceuticallyacceptable salts thereof and a pharmaceutically acceptable carrier.

In an embodiment of the third aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), the unitdosage form comprises from 0.01 mg to 10000 mg of the one or more oddchain fatty acids or pharmaceutically acceptable salts thereof.

In an embodiment of the third aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), the one ormore odd chain fatty acids is heptadecanoic acid.

In an embodiment of the third aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thepharmaceutical composition is substantially free from even chain fattyacids.

In an embodiment of the third aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), thepharmaceutical composition comprises a plurality of odd chain fattyacids.

In an embodiment of the third aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), from 2.5 mgto 11 mg of the one or more odd chain fatty acids or pharmaceuticallyacceptable salts thereof is administered to the patient, per 1 kg ofbody weight, per day.

In an embodiment of the third aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), the one ormore odd chain fatty acids or pharmaceutically acceptable salts thereofis administered to the patient once per day.

In an embodiment of the third aspect (i.e., independently combinablewith any of the aspects or embodiments identified herein), a serumconcentration or a red blood cell membrane concentration of the one ormore odd chain fatty acids is increased by at least about 0.01×10⁻⁴ Mabove a pretreatment value.

Any of the features of an embodiment of the first through third aspectsis applicable to all aspects and embodiments identified herein.Moreover, any of the features of an embodiment of the first throughthird aspects is independently combinable, partly or wholly with otherembodiments described herein in any way, e.g., one, two, or three ormore embodiments may be combinable in whole or in part. Further, any ofthe features of an embodiment of the first through third aspects may bemade optional to other aspects or embodiments. Any aspect or embodimentof a method can be performed by a system or apparatus of another aspector embodiment, and any aspect or embodiment of a system can beconfigured to perform a method of another aspect or embodiment.

DESCRIPTION OF THE DRAWINGS

FIG. 1 provides data for pelargonate for Group A dolphins in anembodiment according to Example 1.

FIG. 2A provides data for total serum adiponectin and percent unmodifiedadiponectin in an embodiment according to Example 1, where symbols andlines correspond to the measured values of total adiponectin (pmol/ml);

FIG. 2B provides data for total serum adiponectin and percent unmodifiedadiponectin in an embodiment according to Example 1. Symbols and linescorrespond to the measured values of percent unmodified adiponectin ineach dolphin from time 0 to week 24;

FIG. 2C provides data for total serum adiponectin and percent unmodifiedadiponectin in an embodiment according to Example 1. Symbols and linescorrespond to the measured values of mean change in total adiponectin;and,

FIG. 2D provides data for total serum adiponectin and percent unmodifiedadiponectin in an embodiment according to Example 1. Symbols and linescorrespond to the measured values of mean percent change in percentunmodified adiponectin for the 6 dolphins at each time point over the24-week study (n=6; except for week 3, n=5) (*denotes P<0.05).

FIG. 3A provides data for serum ceramide 18:1 levels in an embodimentaccording to Example 1 (*=denotes P<0.05);

FIG. 3B provides data for serum ceramide 22:0 levels in an embodimentaccording to Example 1 (*=denotes P<0.05);

FIG. 3C provides provide data for serum ceramide 20:1 levels in anembodiment according to Example 1 (*=denotes P<0.05);

FIG. 3D provides data for serum ceramide 24:0 levels in an embodimentaccording to Example 1 (*=denotes P<0.05);

FIG. 3E provides data for serum ceramide 24:1 levels in an embodimentaccording to Example 1 (*=denotes P<0.05); and,

FIG. 3F provides data for serum ceramide 26:0 levels in an embodimentaccording to Example 1 (*=denotes P<0.05).

FIG. 4A provides data for serum sphingolipid dihydrosphingosine (dSPH)levels in an embodiment according to Example 1;

FIG. 4B provides data for serum dihydrosphingosine 1-phosphoste (dS1P)levels in an embodiment according to Example 1;

FIG. 4C provides data for sphingosine 1-phosphate (SIP) levels in anembodiment according to Example 1; and,

FIG. 4D provides total ceramides and total sphingosines represented asthe sum of dSPH, dS1P, sphingosine, and S1P (*=denotes P<0.05), in anembodiment according to Example 1, where data are reported as mean±SD.

FIG. 5A provides data for serum concentrations of FGF21 in an embodimentaccording to Example 1; wherein symbols and lines correspond to themeasured values of FGF21 (pg/ml) in each dolphin serum at the indicatedcollection time; and,

FIG. 5B provides data for mean change in FGF21 (pg/ml) for the dolphinsera in FIG. 5A at each time point versus week 0.

FIG. 6A provides data for serum proportions of ceramides andsphingosines in dolphins and humans sera at week 0 (n=6); and,

FIG. 6B provides data for dolphin human sera (n=55) sphingosine andceramide proportions, where human serum ceramide concentrations wereextracted from Table 3 in (Argraves et al., 2011) representing a highHDL human group from the Copenhagen City Heart Study (CCHS) collection.

FIG. 7A provides data for dolphin serum ceramides in an embodimentaccording to Example 1; and,

FIG. 7B provides data for human serum ceramides.

FIGS. 8-11 provide data for heptadecanoic acid (as % serum fatty acids)and insulin, glucose, triglycerides, and ferritin, respectively, usingsimple linear regression models in an embodiment according to Example 2.

FIG. 12 provides data for sera heptadecanoic acid levels between a casestudy population of subjects that are highly susceptible to metabolicsyndrome and a control study population with low susceptibility in anembodiment according to Example 2.

FIG. 13 provides data for the amount of heptadecanoic acid in a varietyof fish types and dairy products in an embodiment according to Example2.

FIG. 14 provides data for the comparison of total average daily dietaryintake of heptadecanoic acid in an embodiment according to Example 2.

FIG. 15 provides data for heptadecanoic acid in both subject sera (%) inan embodiment according to Example 2. The dotted line represents themean value for wild dolphins.

FIG. 16 provides data for heptadecanoic acid in subject red blood cell(RBC) membranes (μg/ml) in an embodiment according to Example 2. Thedotted line represents the mean value for wild dolphins.

FIG. 17 provides data for sera insulin levels in an embodiment accordingto Example 2. The dotted line represents the mean value for wilddolphins.

FIG. 18 provides data for sera ferritin in an embodiment according toExample 2.

FIG. 19 provides data for sera ferritin in an embodiment according toExample 2. The dotted line represents the mean value for wild dolphins.

FIG. 20 provides data for sera glucose levels in an embodiment accordingto Example 2. The dotted line represents the mean value for wilddolphins.

FIG. 21 provides data for sera triglyceride levels in an embodimentaccording to Example 2. The dotted line represents the mean value forwild dolphins.

FIG. 22 provides data for heptadecanoic acid (% serum fatty acids)versus insulin in an embodiment according to Example 2. The dotted lineprovides an exemplary serum heptadecanoic acid threshold to maintain lowinsulin.

FIG. 23 provides data for heptadecanoic acid (% serum fatty acids)versus ferritin, in an embodiment according to Example 2. The dottedline provides an exemplary serum heptadecanoic acid threshold tomaintain normal ferritin.

FIG. 24 provides an inverse association between total serum C17:0 andserum ferritin in an embodiment according to Example 1.

FIG. 25 provides data for fasting triglycerides in an embodimentaccording to Example 1.

FIG. 26 provides data for fasting glucose in an embodiment according toExample 1.

FIG. 27 provides data for C17:0 as a percentage of serum fatty acids inan embodiment according to Example 1.

DETAILED DESCRIPTION

Compositions including one or more odd chain fatty acid, and associatedmethods for treatment of metabolic syndrome are provided.

It is an object of certain of the embodiments to provide a method fordetecting protective and risk factors against and for metabolic syndromeand hyperferritinemia in mammal subjects such as dolphins and humans. Anobject of certain of the embodiments is to provide a method for treatingmetabolic syndrome and/or hyperferritinemia in mammal subjects, such asdolphins and humans. An object of certain of the embodiments is toprovide a method for detecting metabolic syndrome and/orhyperferritinemia in mammal subjects, such as for dolphins and humansthat increases the level of heptadecanoic acid of the subject sera. Anobject of certain of the embodiments is to provide a method fordetecting and treating hyperferritinemia without resorting tophlebotomy. An object of certain of the embodiments is to provide aheptadecanoic acid supplement for detecting and treating metabolicsyndrome and hyperferritinemia. An object of certain of the embodimentsis to provide a method for detecting and treating metabolic syndromeand/or hyperferritinemia in mammal subjects, such as dolphins and humansthat is easy to accomplish in a cost-effective manner. An object ofcertain of the embodiments is to provide a method for modulating markersof metabolic syndrome in a subject. An object of certain of theembodiments is to provide a method for detecting metabolic syndrome in asubject. An object of certain of the embodiments is to provide a methodfor treatment of metabolic syndrome in a subject. An object of certainof the embodiments is to provide a method for prophylaxis of metabolicsyndrome in a subject. An object of certain of the embodiments is toprovide a method for increasing an odd chain fatty acid in the sera of asubject. An object of certain of the embodiments is to provide a methodfor detecting or treating hyperferritinemia. An object of certain of theembodiments is to provide an odd chain fatty acid substantially freefrom other fatty acids. An object of certain of the embodiments is toprovide one or more odd chain fatty acids substantially free from evenchain fatty acids.

One or more than one of the aforementioned objects is provided by orachieved by the various compositions, methods, and uses as describedherein.

Definitions

The term “alcohol” as used herein is a broad term, and is to be givenits ordinary and customary meaning to a person of ordinary skill in theart (and is not to be limited to a special or customized meaning), andrefers without limitation to any compound as described hereinincorporating one or more hydroxy groups, or being substituted by orfunctionalized to include one or more hydroxy groups.

The term “derivative” as used herein is a broad term, and is to be givenits ordinary and customary meaning to a person of ordinary skill in theart (and is not to be limited to a special or customized meaning), andrefers without limitation to any compound as described hereinincorporating one or more derivative groups, or being substituted by orfunctionalized to include one or more derivative groups. Derivativesinclude but are not limited to esters, amides, anhydrides, acid halides,thioesters, and phosphates.

The term “hydrocarbon” as used herein is a broad term, and is to begiven its ordinary and customary meaning to a person of ordinary skillin the art (and is not to be limited to a special or customizedmeaning), and refers without limitation to any moiety comprising onlycarbon and hydrogen atoms. A functionalized or substituted hydrocarbonmoiety has one or more substituents as described elsewhere herein.

The term “lipid” as used herein is a broad term, and is to be given itsordinary and customary meaning to a person of ordinary skill in the art(and is not to be limited to a special or customized meaning), andrefers without limitation to saturated and unsaturated oils and waxes,derivatives, amides, glycerides, fatty acids, fatty alcohols, sterol andsterol derivatives, tocopherols, carotenoids, among others.

The terms “pharmaceutically acceptable” as used herein is a broad term,and is to be given its ordinary and customary meaning to a person ofordinary skill in the art (and is not to be limited to a special orcustomized meaning), and refers without limitation to those compounds,materials, compositions, and/or dosage forms which are, within the scopeof sound medical judgment, suitable for contact with the tissues ofand/or for consumption by human beings and animals without excessivetoxicity, irritation, allergic response, or other problem complicationscommensurate with a reasonable risk/benefit ratio.

The terms “pharmaceutically acceptable salts” and “a pharmaceuticallyacceptable salt thereof” as used herein are broad terms, and are to begiven their ordinary and customary meaning to a person of ordinary skillin the art (and is not to be limited to a special or customizedmeaning), and refer without limitation to salts prepared frompharmaceutically acceptable, non-toxic acids or bases. Suitablepharmaceutically acceptable salts include metallic salts, e.g., salts ofaluminum, zinc, alkali metal salts such as lithium, sodium, andpotassium salts, alkaline earth metal salts such as calcium andmagnesium salts; organic salts, e.g., salts of lysine,N,N′-dibenzylethylenediamine, chloroprocaine, choline, diethanolamine,ethylenediamine, meglumine (N-methylglucamine), procaine, and tris;salts of free acids and bases; inorganic salts, e.g., sulfate,hydrochloride, and hydrobromide; and other salts which are currently inwidespread pharmaceutical use and are listed in sources well known tothose of skill in the art, such as, for example, The Merck Index. Anysuitable constituent can be selected to make a salt of the therapeuticagents discussed herein, provided that it is non-toxic and does notsubstantially interfere with the desired activity.

In addition to salts, pharmaceutically acceptable precursors andderivatives of the compounds can be employed. Pharmaceuticallyacceptable amides, lower alkyl derivatives, and protected derivativescan also be suitable for use in compositions and methods of preferredembodiments. While it may be possible to administer the compounds of thepreferred embodiments in the form of pharmaceutically acceptable salts,it is generally preferred to administer the compounds in neutral form.

The term “pharmaceutical composition” as used herein is a broad term,and is to be given its ordinary and customary meaning to a person ofordinary skill in the art (and is not to be limited to a special orcustomized meaning), and refers without limitation to a mixture of oneor more compounds disclosed herein with other chemical components, suchas diluents or carriers. The pharmaceutical composition facilitatesadministration of the compound to an organism. Pharmaceuticalcompositions can also be obtained by reacting compounds with inorganicor organic acids or bases. Pharmaceutical compositions will generally betailored to the specific intended route of administration.

As used herein, a “carrier” as used herein is a broad term, and is to begiven its ordinary and customary meaning to a person of ordinary skillin the art (and is not to be limited to a special or customizedmeaning), and refers without limitation to a compound that facilitatesthe incorporation of a compound into cells or tissues. For example,without limitation, dimethyl sulfoxide (DMSO) is a commonly utilizedcarrier that facilitates the uptake of many organic compounds into cellsor tissues of a subject. Water, saline solution, ethanol, and mineraloil are also carriers employed in certain pharmaceutical compositions.

As used herein, a “diluent” as used herein is a broad term, and is to begiven its ordinary and customary meaning to a person of ordinary skillin the art (and is not to be limited to a special or customizedmeaning), and refers without limitation to an ingredient in apharmaceutical composition that lacks pharmacological activity but maybe pharmaceutically necessary or desirable. For example, a diluent maybe used to increase the bulk of a potent drug whose mass is too smallfor manufacture and/or administration. It may also be a liquid for thedissolution of a drug to be administered by injection, ingestion orinhalation. A common form of diluent in the art is a buffered aqueoussolution such as, without limitation, phosphate buffered saline thatmimics the composition of human blood.

As used herein, an “excipient” as used herein is a broad term, and is tobe given its ordinary and customary meaning to a person of ordinaryskill in the art (and is not to be limited to a special or customizedmeaning), and refers without limitation to a substance that is added toa pharmaceutical composition to provide, without limitation, bulk,consistency, stability, binding ability, lubrication, disintegratingability etc., to the composition. A “diluent” is a type of excipient.

As used herein, a “subject” as used herein is a broad term, and is to begiven its ordinary and customary meaning to a person of ordinary skillin the art (and is not to be limited to a special or customizedmeaning), and refers without limitation to an animal that is the objectof treatment, observation or experiment. “Animal” includes cold- andwarm-blooded vertebrates and invertebrates such as fish, shellfish,reptiles and, in particular, mammals. “Mammal” includes, withoutlimitation, dolphins, mice, rats, rabbits, guinea pigs, dogs, cats,sheep, goats, cows, horses, primates, such as monkeys, chimpanzees, andapes, and, in particular, humans. In some embodiments, the subject ishuman.

As used herein, the terms “treating,” “treatment,” “therapeutic,” or“therapy” are broad terms, and are to be given their ordinary andcustomary meaning (and are not to be limited to a special or customizedmeaning) and, without limitation, do not necessarily mean total cure orabolition of the disease or condition. Any alleviation of any undesiredmarkers, signs or symptoms of a disease or condition, to any extent, canbe considered treatment and/or therapy. Furthermore, treatment mayinclude acts that may worsen the patient's overall feeling of well-beingor appearance.

The terms “therapeutically effective amount” and “effective amount” asused herein are broad terms, and are to be given its ordinary andcustomary meaning to a person of ordinary skill in the art (and are notto be limited to a special or customized meaning), and are used withoutlimitation to indicate an amount of an active compound, orpharmaceutical agent, that elicits the biological or medicinal responseindicated. For example, a therapeutically effective amount of compoundcan be the amount needed to prevent, alleviate or ameliorate markers orsymptoms of a condition or prolong the survival of the subject beingtreated. This response may occur in a tissue, system, animal or humanand includes alleviation of the signs or symptoms of the disease beingtreated. Determination of a therapeutically effective amount is wellwithin the capability of those skilled in the art, in view of thedisclosure provided herein. The therapeutically effective amount of thecompounds disclosed herein required as a dose will depend on the routeof administration, the type of animal, including human, being treated,and the physical characteristics of the specific animal underconsideration. The dose can be tailored to achieve a desired effect, butwill depend on such factors as weight, diet, concurrent medication andother factors which those skilled in the medical arts will recognize.

The term “solvents” as used herein is a broad term, and is to be givenits ordinary and customary meaning to a person of ordinary skill in theart (and is not to be limited to a special or customized meaning), andrefers without limitation to compounds with some characteristics ofsolvency for other compounds or means, that can be polar or nonpolar,linear or branched, cyclic or aliphatic, aromatic, naphthenic and thatincludes but is not limited to: alcohols, derivatives, diesters,ketones, acetates, terpenes, sulfoxides, glycols, paraffins,hydrocarbons, anhydrides, heterocyclics, among others.

Any percentages, ratios or other quantities referred to herein are on aweight basis, unless otherwise indicated.

Odd Chain Fatty Acids

Odd chain fatty acids are saturated and unsaturated fatty acids (see,e.g., Jenkins B, West J, Koulman A (2015), A review of odd-chain fattyacid metabolism and the role of pentadecanoic acid (C15:0) andheptadecanoic acid (C17:0) in health and disease, Molecules 20:2425-44).As provided herein, fatty acids are referred to and described usingconventional nomenclature as is employed by one of skill in the art. Asaturated fatty acid includes no carbon-carbon double bonds. Anunsaturated fatty acid includes at least one carbon-carbon double bond.A monounsaturated fatty acid includes only one carbon-carbon doublebond. A polyunsaturated fatty acid includes two or more carbon-carbondouble bonds. Double bonds in fatty acids are generally cis; however,trans double bonds are also possible. The position of double bonds canbe indicated by An, where n indicates the lower numbered carbon of eachpair of double-bonded carbon atoms. A shorthand notation specifyingtotal # carbons: # double bonds, A double bond positions can beemployed. For example, 20:4A 5,8.11.14 refers to a fatty acid having 20carbon atoms and four double bonds, with the double bonds situatedbetween the 5 and 6 carbon atom, the 8 and 9 carbon atom, the 11 and 12carbon atom, and the 14 and 15 carbon atom, with carbon atom 1 being thecarbon of the carboxylic acid group. Stearate (octadecanoate) is asaturated fatty acid. Oleate (cis-A9-octadecenoate) is a monounsaturatedfatty acid, linolenate (all-cis-A9, 12,15-octadecatrienoate) is apolyunsaturated fatty acid.

An odd chain fatty acid may be referred to by various names, forexample, heptadecanoic acid may be referred to as heptadecylic acid andn-heptadecylic acid, or C17:0. An odd chain fatty acid may be referredto by lipid numbers, as known in the art. Examples of odd chain fattyacids are margaric acid (heptadecanoic acid, C17:0), pelargonate(nonanoic acid, C9:0), undecanoic acid (C11:0), nonadecanoic acid(C19:0), arachidonate ((5Z,8Z,11Z,14Z)-icosa-5,8, 11,14-tetraenoicacid), adrenate (all-cis-7,10,13,16-docosatetraenoic acid), and osbondacid (all-cis-4,7,10,13,16-docosapentaenoic acid). Generally, the one ormore odd chain fatty acids have from 9 carbon atoms to 31 carbon atoms(9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, or 31 carbon atoms), forexample, from 15 to 21 carbon atoms, for example 17 carbon atoms;however, in certain embodiments higher or lower odd numbers of carbonatoms can be acceptable. Generally, the one or more odd chain fattyacids are saturated; however, in certain embodiments mono orpolyunsaturated odd chain fatty acids can be acceptable.

An odd chain fatty acid may include saturated or unsaturated hydrocarbonchains. An odd chain fatty acid may be present as a carboxylicderivative. An odd chain fatty acid may be present as a salt, forexample, at the carboxylic group. In some embodiments, one odd chainfatty acid may be present, two odd chain fatty acids may be present,three odd chain fatty acids may be present, or more. In someembodiments, odd chain fatty acids in a mixture including a plurality ofodd chain fatty acids may be distinguished by the amount ofunsaturation, the length of the hydrocarbon chain, varying states ofderivativeification, or by other structural features.

Odd chain fatty acids are found in trace amounts in some dairy products,including butter, and is a component of some fish oils (see, e.g.,Mansson H L (2008), Fatty acids in bovine milk fat, Food Nutr. Res.52:4, Luzia L A, Sampaia G R, Castellucci C M N, Torres EAFS (2013) Theinfluence of season on the lipid profiles of five commercially importantspecies of Brazilian fish. Food Chem. 83:93-97). Studies havedemonstrated that increasing daily dietary intake of foods with oddchain fatty acids successfully increases serum levels (see, e.g.,Benatar J. R., Stewart R A H. (2014), The effects of changing dairyintake on trans and saturated fatty acid levels—results from arandomized controlled study. Nutr. J. 13:32).

The prevalence of various fatty acids in the diet has been correlated tothe occurrence of metabolic syndrome in subjects (see, e.g., Forouhi N,Koulman A, Sharp S, Imamura F, Kroger J, Schulze M, et al. (2014),Differences in the prospective association between individual plasmaphospholipid saturated fatty acids and incident type 2 diabetes: theEPIC-InterAct case-cohort study. Lancet Diabetes Endocrinol. 2:810-8).Indeed, whole-fat dairy consumption has been correlated with a decreasedrisk of metabolic syndrome markers (see, e.g., Kratz M, Marcovina S,Nelson J E, Yeh M M, Kowdley K V, Callahan H S, et al. (2014), Dairy fatintake is associated with glucose tolerance, hepatic and systemicinsulin sensitivity, and liver fat but not beta-cell function in humans,Am. J. Clin. Nutr., 99: 1385-96).

A pure or purified odd chain fatty acid may exist in various physicalstates. For example, heptadecanoic acid exists as an off-white powderthat is stable at room temperature; this compound can be purchased informs suitable for research purposes in small amounts from somecommercial suppliers (for example, from Sigma-Aldrich corp., of St.Louis, Mo.). Other odd chain fatty acids, or salts or derivativesthereof, may exist as oils, solids, crystalline solids, or gases.

An odd chain fatty acid, or its pharmaceutically acceptable salts orderivatives, may be provided in a purity (e.g., a percentage of the oddchain fatty acid, or its pharmaceutically acceptable salts orderivatives, in a bulk form) of at least about 10%, at least about 20%,at least about 30%, at least about 40%, at least about 50%, at leastabout 60%, at least about 70%, at least about 80%, at least about 90%,at least about 95%, at least about 98%, at least about 99%, at leastabout 99.9%, at least about 99.99%, or substantially pure, whereinsubstantially pure may include, but not be limited to, a product withimpurities at a level such that no physiological effect from thepresence of the impurities is detectable. A mixture of odd chain fattyacids, or pharmaceutically acceptable salts or derivatives thereof, maybe present in a purity of at least about 10%, at least about 20%, atleast about 30%>, at least about 40%, at least about 50%, at least about60%, at least about 70%, at least about 80%, at least about 90%, atleast about 95%, at least about 98%, at least about 99%, at least about99.9%, at least about 99.99%, or substantially pure. An odd chain fattyacid, or a mixture thereof, or a pharmaceutically acceptable salt orderivative thereof, may be free from other fatty acids or fatty acidderivatives, may be free from triglycerides, or may be free fromphospholipids. Without limitation, an odd chain fatty acid as providedherein may be substantially free from even chain fatty acids, singly ortaken as a group; even chain fatty acids include, for example, myristicacid (C14:0), palmitic acid (C16:0), stearic acid (C18:0), or arachidicacid (C20:0). In some embodiments, an odd chain fatty acid as providedherein may be substantially free from short-chain fatty acids (SCFA),medium-chain fatty acids (MCFA), long-chain fatty acids (LCFA), or verylong chain fatty acids (VLCFA).

An odd chain fatty acid, or a pharmaceutically acceptable salt orderivative thereof, may be from any source. In some embodiments, an oddchain fatty acid, or its pharmaceutically acceptable salts orderivatives, may be present in natural sources, may be isolated fromnatural sources, may be semi-synthetic, may be synthetic, or may be amixture of one or more of these. An odd chain fatty acid, or itspharmaceutically acceptable salts or derivatives, may be produced in alaboratory, may be produced in nature, may be produced by enzymaticprocesses, may be produced by wild microbes, may be produced bygenetically modified microbes, may be isolated from animal tissues, maybe produced by chemical synthesis, or may be produced by a plurality ofthese processes.

An odd chain fatty acid may be derived from natural sources, e.g., fishoils, or can be synthesized by methods as are known in the art. In someembodiments, an odd chain fatty acid may be contaminated with even chainfatty acids, or other components present in unrefined or unpurifiednatural products. In such situations, it can be desirable to removeundesired components, or to increase the concentration of desiredcomponents using known separation or purification techniques.

In any compound described, all tautomeric forms are also intended to beincluded. Without limitation, all tautomers of carboxylic groups areintended to be included.

In any compound described herein having one or more double bond(s)generating geometrical isomers that can be defined as E or Z, eachdouble bond may independently be E or Z, or a mixture thereof.

Where compounds disclosed herein have unfilled valencies, then thevalencies are to be filled with hydrogens or isotopes thereof, e.g.,hydrogen-1 (protium) and hydrogen-2 (deuterium).

An odd chain fatty acid, as described herein, includes crystalline forms(also known as polymorphs, which include the different crystal packingarrangements of the same elemental composition of a compound), amorphousphases, salts, solvates, and hydrates. In some embodiments, thecompounds described herein exist in solvated forms with pharmaceuticallyacceptable solvents such as water, ethanol, or the like. In otherembodiments, the compounds described herein exist in unsolvated form.Solvates contain either stoichiometric or non-stoichiometric amounts ofa solvent, and may be formed during the process of crystallization withpharmaceutically acceptable solvents such as water, ethanol, or thelike. Hydrates are formed when the solvent is water, or alcoholates areformed when the solvent is alcohol. In addition, the compounds providedherein can exist in unsolvated as well as solvated forms. In general,the solvated forms are considered equivalent to the unsolvated forms forthe purposes of the compounds and methods provided herein.

The compounds described herein can be labeled isotopically. In somecircumstances, substitution with isotopes such as deuterium may affordcertain therapeutic advantages resulting from greater metabolicstability, such as, for example, increased in vivo half-life or reduceddosage requirements. Isotopic substitution may be beneficial inmonitoring subject response to administration of a compound, forexample, by providing opportunity for monitoring of the fate of an atomin a compound. Each chemical element as represented in a compoundstructure may include any isotope of said element. For example, in acompound structure a hydrogen atom may be explicitly disclosed orunderstood to be present in the compound. At any position of thecompound that a hydrogen atom may be present, the hydrogen atom can beany isotope of hydrogen, including but not limited to hydrogen-1(protium) and hydrogen-2 (deuterium). Thus, reference herein to acompound encompasses all potential isotopic forms unless the contextclearly dictates otherwise.

Pharmaceutical Compositions Including One or More Odd Chain Fatty Acids

Formulations including an odd chain fatty acid, or a salt or derivativethereof, and at least one excipient are provided. It is generallypreferred to administer the compounds of the embodiments in oralformulations; however, other routes of administration are alsocontemplated.

The pharmaceutical compositions described herein can be administered bythemselves to a subject, or in compositions where they are mixed withother active agents, as in combination therapy, or with carriers,diluents, excipients or combinations thereof. Formulation is dependentupon the route of administration chosen. Techniques for formulation andadministration of the compounds described herein are known to thoseskilled in the art (see, e.g., “Remington: The Science and Practice ofPharmacy”, Lippincott Williams & Wilkins; 20th edition (Jun. 1, 2003)and “Remington's Pharmaceutical Sciences,” Mack Pub. Co.; 18th and 19theditions (December 1985, and June 1990, respectively).

The pharmaceutical compositions disclosed herein may be manufactured bya process that is itself known, e.g., by means of conventional mixing,dissolving, granulating, dragee-making, levigating, emulsifying,encapsulating, entrapping, tableting, or extracting processes. Many ofthe compounds used in the pharmaceutical combinations disclosed hereinmay be provided as salts with pharmaceutically acceptable counterions.

Multiple techniques of administering a compound exist in the artincluding, but not limited to, oral, rectal, topical, aerosol, injectionand parenteral delivery, including intramuscular, subcutaneous,intravenous, intramedullary injections, intrathecal, directintraventricular, intraperitoneal, intranasal and intraocularinjections. Contemplated herein is any combination of the forgoing, orother methods as would be known to one of ordinary skill in the art(see, e.g., “Remington: The Science and Practice of Pharmacy”,Lippincott Williams & Wilkins; 20th edition (Jun. 1, 2003) and“Remington's Pharmaceutical Sciences,” Mack Pub. Co.; 18th and 19theditions (December 1985, and June 1990, respectively).

In practice, an odd chain fatty acid, or a salt or derivative thereof,may be combined as the active ingredient in intimate admixture with apharmaceutical carrier according to conventional pharmaceuticalcompounding techniques. The carrier can take a wide variety of formsdepending on the form of preparation desired for administration. Thus,the pharmaceutical compositions provided herein can be presented asdiscrete units suitable for oral administration such as capsules,cachets or tablets each containing a predetermined amount of the activeingredient. Further, the compositions can be presented as an oil, apowder, as granules, as a solution, as a suspension in an aqueousliquid, as a non-aqueous liquid, as an oil-in-water emulsion, or as awater-in-oil liquid emulsion. In addition to the common dosage forms setout above, the compounds provided herein, or pharmaceutically acceptablesalts or derivatives thereof, can also be administered by controlledrelease means and/or delivery devices. The compositions can be preparedby any of the methods of pharmacy. In general, such methods include astep of bringing into association the active ingredient with the carrierthat constitutes one or more necessary ingredients. In general, thecompositions are prepared by uniformly and intimately admixing theactive ingredient with liquid carriers or finely divided solid carriersor both. The product can then be conveniently shaped into the desiredpresentation.

A formulation may also be administered in a local rather than systemicmanner, for example, via injection of the compound directly into theinfected area, often in a depot or sustained release formulation.Furthermore, a targeted drug delivery system might be used, for example,in a liposome coated with a tissue specific antibody.

The pharmaceutical compositions may contain an odd chain fatty acid, ora salt or derivative thereof, in an amount effective for the desiredtherapeutic effect. In some embodiments, the pharmaceutical compositionsare in a unit dosage form and comprise from about 0.1 mg or less toabout 5000 mg or more per unit dosage form. In further embodiments, thepharmaceutical compositions comprise from about 1 to about 500 mg perunit dosage form or from about 500 to 5000 mg per unit dosage form. Suchdosage forms may be solid, semisolid, liquid, an emulsion, or adaptedfor delivery via aerosol or the like for inhalation administration.

The pharmaceutical carrier employed can be, for example, a solid,liquid, or gas. Examples of solid carriers include lactose, terra alba,sucrose, talc, gelatin, agar, pectin, acacia, magnesium stearate, andstearic acid. Examples of liquid carriers are sugar syrup, peanut oil,olive oil, lower alcohols, and water. Examples of gaseous carriersinclude carbon dioxide and nitrogen.

Pharmaceutical compositions provided herein can be prepared as solutionsor suspensions of the active compound(s) in water. A suitable surfactantcan be included such as, for example, hydroxypropylcellulose.Dispersions can also be prepared in glycerol, liquid polyethyleneglycols, and mixtures thereof in oils. Further, a preservative can beincluded to, for example, prevent the detrimental growth ofmicroorganisms.

Pharmaceutical compositions provided herein suitable for injectable useinclude sterile aqueous solutions or dispersions. Furthermore, thecompositions can be in the form of sterile powders for theextemporaneous preparation of such sterile injectable solutions ordispersions. The pharmaceutical compositions must be stable under theconditions of manufacture and storage; thus, preferably should bepreserved against the contaminating action of microorganisms such asbacteria and fungi. The carrier can be a solvent or dispersion mediumcontaining, for example, water, ethanol, polyol (e.g., glycerol,propylene glycol and liquid polyethylene glycol), vegetable oils, andsuitable mixtures thereof.

In addition to the aforementioned carrier ingredients, thepharmaceutical formulations described above can include, as appropriate,one or more additional carrier ingredients such as diluents, buffers,flavoring agents, binders, surface-active agents, thickeners,lubricants, preservatives (including anti-oxidants) and the like.Furthermore, other adjuvants can be included to render the formulationisotonic with the blood of the intended recipient. Compositionscontaining a compound provided herein, or pharmaceutically acceptablesalt or derivative thereof, can also be prepared in powder or liquidconcentrate form for dilution.

Contemplated herein are compositions including an odd chain fatty acidor a salt or derivative thereof in combination with at least oneadditional active agent. An odd chain fatty acid, or a salt orderivative thereof, and the at least one additional active agent(s) maybe present in a single formulation or in multiple formulations providedtogether, or may be unformulated. In some embodiments, an odd chainfatty acid, or a salt or derivative thereof, can be administered withone or more additional agents together in a single composition. Forexample, a compound of an odd chain fatty acid, or a salt or derivativethereof, can be administered in one composition, and at least one of theadditional agents can be administered in a second composition. In afurther embodiment, an odd chain fatty acid or a salt or derivativethereof and the at least one additional active agent(s) are co-packagedin a kit. For example, a drug manufacturer, a drug reseller, aphysician, a compounding shop, or a pharmacist can provide a kitcomprising a disclosed compound or product and another component fordelivery to a patient.

Some embodiments described herein relate to a pharmaceuticalcomposition, which can include a therapeutically effective amount of oneor more compounds described herein (e.g., an odd chain fatty acid, or apharmaceutically acceptable salt or derivative thereof) and apharmaceutically acceptable carrier, diluent, excipient or combinationthereof. The pharmaceutical composition can include an odd chain fattyacid or a salt or derivative thereof in, for example, ≥1%, ≥2%, ≥3%,≥4%, ≥5%, ≥6%, ≥7%, ≥8%, ≥9%, ≥10%, ≥20%, ≥30%, ≥40%, ≥50%, ≥60%, ≥70%,≥80%, ≥90%, ≥95%, or ≥98% of the composition. In some embodiments, thepharmaceutical composition can include a plurality of odd chain fattyacids, or salts or derivatives thereof in, for example, ≥1%, ≥2%, ≥3%,≥4%, ≥5%, ≥6%, ≥7%, ≥8%, ≥9%, ≥10%, ≥20%, ≥30%, ≥40%, ≥50%, ≥60%, ≥70%,≥80%, ≥90%, ≥95%, or ≥98% of the composition.

Foodstuffs

Foodstuffs and other comestibles including an odd chain fatty acid, or asalt or derivative thereof, are provided, wherein an amount of the oddchain fatty acid in the foodstuff has been fortified (e.g., enriched orconcentrated). An odd chain fatty acid provided herein may be added tofoodstuffs for consumption by a subject. The odd chain fatty acid may beintegrated into one or more ingredients of a foodstuff. The odd chainfatty acid may be prepared as an ingredient, or may be unprepared. Thecompound, or preparation including the compound, may be added prior topreparation, during preparation, or following preparation. Preparationmay without limitation include cooking, mixing, flavoring, seasoning,blending, boiling, frying, baking, or other processes known in the art.Fortification is preferably at a level so as to provide a therapeuticdaily dosage of the odd chain fatty acid as described elsewhere herein;however, beneficial effects may also be obtained at amounts below suchdosages.

An odd chain fatty acid, or salt or derivative thereof, as providedherein may be present as a constituency in foodstuffs by operation ofprocesses known in nature, for example, by altering the metabolicprocesses of a plant, animal, bacteria, or fungus. Genetic alteration ofa plant, animal, bacteria, or fungus to increase the concentration of anodd chain fatty acid, or a salt or derivative thereof, is contemplated.By way of example, the odd chain fatty acid can be present in thefoodstuff in a concentration of at least about 1%, at least about 2%, atleast about 3%, at least about 4%, at least about 5%, at least about 6%,at least about 7%, at least about 8%, at least about 9%, at least about10%, at least about 20%, at least about 30%, at least about 40%, atleast about 50%, or higher, for example, 1% to 2% or 3% or 4% or 5% or6% or 7% or 8% or 9% or 10% or 20% or 30% or 40% or 50%.

Indications

Provided herein are compositions and methods for treating conditionsincluding but not limited to metabolic syndrome, diabetes type I,diabetes type II, obesity, pre-diabetes, glucose intolerance,gestational diabetes mellitus (GDM), impaired fasting glycemia (IFG),hyperferritinemia, impaired adiponectin production, postprandialhyperglycemia, dyslipidemia, post prandial dyslipidemia, hyperlipidemia,hypertriglyceridemia, post hypertriglyceridemia, insulin resistance,polycystic ovary syndrome (PCOS), non-alcoholic fatty liver disease(NAFL), non-alcoholic steatohepatitis (NASH), hypoinsulinemia, fattyliver disease, elevated glucose levels, elevated insulin levels, andelevated LDL triglyceride levels.

In some embodiments, the compositions and methods provided herein areindicated for treatment, prophylaxis, prevention or maintenance ofmetabolic syndrome.

Metabolic syndrome as described herein generally relates to a cluster ofrisk factors that are associated with a number of conditions asdescribed herein, including but not limited to diabetes (especially type2 diabetes), hypertension, cardiovascular disease, and other conditionssuch as polycystic ovary syndrome, fatty liver, cholesterol gallstones,asthma, sleep disturbances, some forms of cancer, ischemia, oxidativestress, atherosclerosis, obesity, abnormal lipid metabolism, and stroke(see, e.g., Grundy S. M, et al, Definition of Metabolic Syndrome (2004),Circulation, 109: 433-438). Risk factors of metabolic syndrome includeabdominal (central) obesity, elevated blood pressure, advanced age, andsmoking. Indicators of metabolic syndrome, which may but need notpresent, include insulin resistance, elevated fasting plasma glucose,glucose intolerance, high serum triglycerides, abnormal serum lipids,decreased high-density lipoprotein (HDL) levels, body mass index (BMI),proinflammatory state, and prothrombotic state.

Metabolic syndrome is also correlated with hyperferritinemia (with orwithout iron overload), which is itself associated with impairedproduction of the insulin sensitizing hormone adiponectin. Not wishingto be bound by theory, it appears that increased adiponectin levels areassociated with better glycemic control and better lipid profiles(Schulze, M. B., et al (2004), Relationship between adiponectin andglycemic control, blood lipids, and inflammatory markers in men withtype 2 diabetes. Diabetes Care 27, 1680-1687; Mantzoros, et al (2005),Circulating adiponectin levels are associated with better glycemiccontrol, more favorable lipid profile, and reduced inflammation in womenwith type 2 diabetes. J. Clin. Endocrinol. Metab. 90, 4542-4548).

While a cluster of signs and symptoms may coexist in an individualsubject, in many cases only one or a few symptoms may dominate, due toindividual differences in vulnerability of the many physiologicalsystems affected.

Insulin resistance can be defined in many different ways, includingimpaired glucose metabolism (reduced clearance of glucose and/or thefailure to suppress glucose production), the inability to suppresslipolysis in tissues, defective protein synthesis, altered celldifferentiation, aberrant nitric oxide synthesis affecting regionalblood flow, as well as abnormal cell cycle control and proliferation.Insulin resistance may also be indicated by serum protein concentrationsof, for example, fibroblast growth factor 21 (“FGF21”), totaladiponectin, and % unmodified adiponectin.

Serum lipid concentrations that may indicate metabolic syndrome andassociated conditions include, for example, ceramides, andsphingolipids, for example, sphingosine, dihydrosphingosine,sphingosine-1-phosphate, and dihydrosphingosine-1-phosphate.

Disease symptoms secondary to hyperglycemia or other conditions may alsooccur in patients with metabolic syndrome. Because the compositions andmethods provided herein help to reduce hyperglycemia in diabetes andother conditions related to metabolic syndrome, they are useful forprevention and amelioration of complications of these conditions. Thecompounds and methods provided herein are useful for prevention oramelioration of virtually any symptom that may be due to, or exacerbatedby, metabolic syndrome and related conditions.

Serum odd chain fatty acids levels are correlated with improved indicesfor metabolic syndrome. However, the mechanism by which odd chain fattyacids act to inhibit or lessen metabolic syndrome or markers ofmetabolic syndrome is not presently well understood. The methods andmarkers provided herein are not to be construed as limited to anyparticular mechanism, mode of action, or theory. Accordingly, methods oftreating, preventing or ameliorating metabolic syndrome are provided.

Provided herein are compositions and methods for preventing or treatingdiabetes in a wide range of subjects, including in particular a humanpatient that has, has had, is suspected of having, or who ispre-disposed to developing diabetes. Diabetes mellitus may be referredto as, for example, insulin-dependent diabetes mellitus (EDDM or type Idiabetes) and non-insulin-dependent diabetes mellitus (NIDDM, or type IIdiabetes). Examples of disorders related to diabetes mellitus have beendescribed and include, but are not limited to, impaired glucosetolerance (IGT), maturity-onset diabetes of youth (MODY), leprechaunism(insulin receptor mutation), tropical diabetes, diabetes secondary to apancreatic disease or surgery, diabetes associated with a geneticsyndrome (e.g., Prader-Willi syndrome), pancreatitis, diabetes secondaryto endocrinopathies, adipositas, and metabolic syndrome.

Diabetic subjects appropriate for treating using the compositions andmethods provided herein may be identified by the risk factors, indicesand markers provided herein, and by other indications available toclinicians, and are characterized by, e.g., fasting hyperglycemia,impaired glucose tolerance, glycosylated hemoglobin, and, in someinstances, ketoacidosis associated with trauma or illness. Hyperglycemiaor high blood sugar is a condition in which an excessive amount ofglucose circulates in the blood plasma. This is generally considered tobe a blood glucose level of 10+ mmol/L, but symptoms and effects may notstart to become noticeable until later numbers such as 15-20+ mmol/L.NIDDM patients have an abnormally high blood glucose concentration whenfasting and delayed cellular uptake of glucose following meals or aftera diagnostic test known as the glucose tolerance test. NIDDI isdiagnosed based on recognized criteria (American Diabetes Association,Physician's Guide to Insulin-Dependent (Type I) Diabetes, 1988; AmericanDiabetes Association, Physician's Guide to Non-Insulin-Dependent (TypeII) Diabetes, 1988).

In some embodiments, the compositions and methods provided herein areindicated for treatment, prevention and or maintenance of conditions,disorders, diseases and defects associated with energy homeostasis.Energy homeostasis generally relates to the signal pathways, moleculesand hormones associated with food intake and energy expenditure.Disorders, diseases and defects associated with energy homeostasisinclude but are not limited to diabetes type I, diabetes type II,prediabetes, impaired fasting glycemia (IFG), impaired post-prandialglucose, and gestational diabetes. In some instances the compositionsand methods provided herein are indicated for treatment, prevention andor maintenance of diabetes type I or type II.

In some embodiments, the compositions and methods provided herein areindicated for treatment, prevention and or maintenance of conditions,disorders, diseases and defects associated with fuel homeostasis.Disorders, diseases and defects associated with fuel homeostasis includebut are not limited to non-alcoholic fatty liver disease (NAFL),non-alcoholic steatohepatitis (NASH), hyperlipidemia, posthypertriglyceridemia, hypertriglyceridemia, insulin resistance andpolycystic ovary syndrome (PCOS).

In some embodiments, the compositions and methods provided herein areindicated for treatment, prevention, or maintenance ofhyperferritinemia. High ferritin and iron overload have been associatedwith metabolic syndrome and diabetes in humans. It is unknown preciselywhy ferritin increases in some people and how high ferritin increasesthe risk of metabolic syndrome. While not wishing to be bound by theory,it is believed that direct injury to the liver and pancreas fromexcessive deposition, or indirect injury from increased oxidativeradicals, may be causative factors. In some embodiments, the compoundsand methods provided herein lead to reduced serum iron; in someembodiments, the compounds and methods provided herein lead to reducedserum ferritin; in some embodiments, the compounds and methods providedherein ameliorate hyperferritinemia without phlebotomy.

Elevated triglyceride (e.g., LDL) is an important risk factor foratherosclerosis and myocardial infarction. Provided herein arecompositions and methods useful for reducing circulating triglyceridesin hyperlipidemic patients. Cholesterol-lowering drugs such as HMG-CoAreductase inhibitors (“statins”) can be administered to subjects inaddition to compounds provided herein, optionally incorporated into thesame pharmaceutical composition.

In some embodiments provided herein, the subject may be a dolphin;however, it is generally contemplated that the methods, uses, andcompositions of the embodiments are applied to humans. Like humansubjects, bottlenose dolphin (Tursiops truncatus) subjects can also besusceptible to metabolic syndrome, including high insulin, glucose,triglycerides, fatty liver disease, and iron overload. Iron overload indolphins, involving excessive iron deposition primarily in the liver'sKupffer cells, can be progressive with age and can be associated withelevated insulin, lipids, and liver enzymes. This disease is associatedwith neither mutations in the HFE gene nor increases in studied acutephase proteins. Similar to humans, iron overload in dolphins is treatedwith phlebotomy, and repeated treatments are needed throughout life dueto returning elevations of serum ferritin. The underlying causes of ironoverload and hyperferritinemia in dolphins are unknown.

In some embodiments, the condition treated is metabolic syndrome.

In some embodiments, the condition treated is metabolic syndrome asindicated by the markers provided herein.

In some embodiments, the methods provided herein modulate markers ofmetabolic syndrome when the markers provide a clinical indication.

In some embodiments, the methods provided herein alleviate symptoms ofmetabolic syndrome.

In some embodiments, the methods provided herein reduce risk ofmetabolic syndrome.

In some embodiments, the condition treated is hyperferritinemia.

In some embodiments, the methods provided herein increase levels ofserum odd chain fatty acids.

In some embodiments, the methods provided herein improve insulinsensitivity.

In some embodiments, the compositions and methods provided hereinmodulate a marker of metabolic syndrome. In certain embodiments, themarker is serum or red blood cell membrane odd chain fatty acidpercentage, serum concentration of an odd chain fatty acid, serum totalodd chain fatty acid, serum ferritin, serum iron, transferritinsaturation, serum glucose (for example fasting glucose), serumtriglycerides, blood pressure, adiponectin, HDL cholesterol,microalbuminuria (i.e., elevated albumin excretion in the urine), CRP (Creactive protein), IL-6 and TNFα (and other cytokines associated withinsulin resistance), c-Jun N-terminal kinase (JNK), ATM (AtaxiaTelangiectasia Mutated) or monocyte-chemoattractant protein-1. In someembodiments, the odd chain fatty acid is measured as a constituent ofglycolipids. In further embodiments, the odd chain fatty acid ismeasured as a constituent of phospholipids.

In some embodiments, the methods provided herein include the step ofmeasuring the concentration of a marker of metabolic syndrome. One ofskill in the art will be able to perform suitable methods for suchmeasurements, including but not limited to those described herein.

Provided herein are methods for treating including the step ofadministering a dose of an odd chain fatty acid at a predeterminedinterval, or at an interval left to the discretion of the subject.

In some embodiments, the compounds and methods provided herein mayprovide a threshold serum or red blood cell membrane percentage of anodd chain fatty acid relative to all serum or red blood cell membranefatty acids, respectively. For example, the threshold value may be avalue of about 0.05% or lower to 90% or higher, e.g., a value of atleast about 0.05%, at least about 0.1%, at least about 0.2%, at leastabout 0.3%, at least about 0.4%, at least about 0.5%, at least about0.6%, at least about 0.7%, at least about 0.8%, at least about 0.9%, atleast about 1.0%, at least about 1.1%, at least about 1.2%, at leastabout 1.3%, at least about 1.4%, at least about 1.5%, at least about1.6%, at least about 1.7%, at least about 1.8%, at least about 1.9%, atleast about 2.1%, at least about 2.2%, at least about 2.3%, at leastabout 2.4%, at least about 2.5%, at least about 2.6%, at least about2.7%, at least about 2.8%, at least about 2.9%, at least about 3.0%, atleast about 3.5%, at least about 4.0%, at least about 4.5%, at leastabout 5%, at least about 6%, at least about 7%, at least about 8%, atleast about 9%, at least about 10%, at least about 15%, at least about20%, at least about 25%, at least about 30%, at least about 35%, atleast about 40%, at least about 45%, at least about 50%, at least about60%, at least about 70%, at least about 80%, at least about 90%, or morethan 90%.

In some embodiments, the compounds and methods provided herein mayprovide an increase above a baseline value (e.g., pretreatment value ina patient being treated, or general value observed in a particularpatient population) in a serum concentration of an odd chain fatty acid,or red blood cell membrane concentration of an odd chain fatty acid. Forexample, a serum odd chain fatty acid or red blood cell membraneconcentration of an odd chain fatty acid may be increased by at leastabout 1 μg/ml, at least about 2 μg/ml, at least about 3 μg/ml, at leastabout 4 μg/ml, at least about 5 μg/ml, at least about 6 μg/ml, at leastabout 7 μg/ml, at least about 8 μg/ml, at least about 9 μg/ml, at leastabout 10 μg/ml, at least about 15 μg/ml, at least about 20 μg/ml, atleast about 25 μg/ml, at least about 30 μg/ml, at least about 35 μg/ml,at least about 40 μg/ml, at least about 45 μg/ml, at least about 50μg/ml, or more than 50 μg/ml. In some embodiments, the serumconcentration of an odd chain fatty acid, or red blood cell membraneconcentration of an odd chain fatty acid may increase above a baselinevalue (e.g., pretreatment value in a patient being treated, or generalvalue observed in a particular patient population) by at least about0.01×10⁻⁴ M, at least about 0.05×10⁻⁴ M, at least about 0.1×10⁻⁴ M, atleast about 0.2×10⁻⁴ M, at least about 0.3×10⁻⁴ M, at least about0.4×10⁻⁴ M, at least about 0.5×10⁻⁴ M, at least about 0.6×10⁻⁴ M, atleast about 0.7×10⁻⁴M, at least about 0.8×10⁻⁴ M, at least about0.9×10⁻⁴ M, at least about 1×10⁻⁴ M, at least about 2×10⁻⁴ M, or atleast about 3×10⁻⁴ M.

In some embodiments, the compounds and methods provided herein mayprovide an increase in serum total odd chain fatty acids, or red bloodcell membrane total odd chain fatty acids. For example, serum total oddchain fatty acids, or red blood cell membrane total odd chain fattyacids, may be increased above a baseline value (e.g., pretreatment valuein a patient being treated, or general value observed in a particularpatient population) by at least about 5 μg/ml, at least about 6 μg/ml,at least about 7 μg/ml, at least about 8 μg/ml, at least about 9 μg/ml,at least about 10 μg/ml, at least about 15 μg/ml, at least about 20μg/ml, at least about 25 μg/ml, at least about 30 μg/ml, at least about35 μg/ml, at least about 40 μg/ml, at least about 45 μg/ml, at leastabout 50 μg/ml, at least about 60 μg/ml, at least about 70 μg/ml, atleast about 80 μg/ml, at least about 90 μg/ml, at least about 100 μg/ml,at least about 150 μg/ml, at least about 200 μg/ml, at least about 250μg/ml, at least about 300 μg/ml, at least about 350 μg/ml, at leastabout 400 μg/ml, at least about 450 μg/ml, at least about 500 μg/ml, ormore than 500 μg/ml.

In some embodiments, the compounds and methods provided herein mayprovide an increase above a baseline value (e.g., pretreatment value ina patient being treated, or general value observed in a particularpatient population) in a serum or red blood cell membrane odd chainfatty acids relative to all serum or red blood cell membrane fattyacids, respectively. For example, a serum or red blood cell membrane oddchain fatty acid may be increased above a baseline value (e.g.,pretreatment value in a patient being treated, or general value observedin a particular patient population) by at least about 0.01%, at leastabout 0.05%, at least about 0.1%, at least about 0.2%, at least about0.3%, at least about 0.4%, at least about 0.5%, at least about 0.6%, atleast about 0.7%, at least about 0.8%, at least about 0.9%, at leastabout 1%, at least about 1.1%, at least about 1.2%, at least about 1.3%,at least about 1.4%, at least about 1.5%, at least about 1.6%, at leastabout 1.7%, at least about 1.8%, at least about 1.9%, at least about 2%,at least about 2.1%, at least about 2.2%, at least about 2.3%, at leastabout 2.4%, at least about 2.5%, at least about 2.6%, at least about2.7%, at least about 2.8%, at least about 2.9%, at least about 3%, atleast about 3.5%, at least about 4%, at least about 4.5%, at least about5%, or more than 5%.

In some embodiments, the compounds and methods provided herein mayprovide a reduction in serum insulin. For example, serum insulin may bereduced below a baseline value (e.g., pretreatment value in a patientbeing treated, or general value observed in a particular patientpopulation) by at least about 0.1 μIU/ml, at least about 0.2 μIU/ml, atleast about 0.3 μIU/ml, at least about 0.4 μIU/ml, at least about 0.5μIU/ml, at least about 0.6 μIU/ml, at least about 0.7 μIU/ml, at leastabout 0.8 μIU/ml, at least about 0.9 μIU/ml, at least about 1.0 μIU/ml,at least about 1.1 μIU/ml, at least about 1.2 μIU/ml, at least about 1.3μIU/ml, at least about 1.4 μIU/ml, at least about 1.5 μIU/ml, at leastabout 2 μIU/ml, at least about 2.5 μIU/ml, at least about 3.0 μIU/ml, atleast about 3.5 μIU/ml, at least about 4 μIU/ml, at least about 5μIU/ml, at least about 6 μIU/ml, at least about 7 μIU/ml, at least about8 μIU/ml, at least about 9 μIU/ml, at least about 10 μIU/ml, at leastabout 11 μIU/ml, at least about 12 μIU/ml, at least about 13 μIU/ml, atleast about 14 μIU/ml, at least about 15 μIU/ml, at least about 16μIU/ml, at least about 17 μIU/ml, at least about 18 μIU/ml, at leastabout 19 μIU/ml, at least about 20 μIU/ml, at least about 25 μIU/ml, atleast about 30 μIU/ml, or more than 30 μIU/ml.

In some embodiments, the compounds and methods provided herein mayprovide a reduction in serum triglycerides. For example, serumtriglycerides may be reduced below a baseline value (e.g., pretreatmentvalue in a patient being treated, or general value observed in aparticular patient population) by at least about 1 mg/dl, at least about3 mg/dl, at least about 4 mg/dl, at least about 5 mg/dl, at least about10 mg/dl, at least about 15 mg/dl, at least about 20 mg/dl, at leastabout 25 mg/dl, at least about 30 mg/dl, at least about 35 mg/dl, atleast about 40 mg/dl, at least about 45 mg/dl, at least about 50 mg/dl,at least about 60 mg/dl, at least about 70 mg/dl, at least about 80mg/dl, at least about 90 mg/dl, at least about 100 mg/dl, at least about110 mg/dl, at least about 120 mg/dl, at least about 130 mg/dl, at leastabout 140 mg/dl, at least about 150 mg/dl, at least about 200 mg/dl, atleast about 250 mg/dl, at least about 300 mg/dl, or more than 300 mg/dl.

In some embodiments, the compounds and methods provided herein mayprovide a reduction in serum ferritin. For example, serum ferritin maybe reduced below a baseline value (e.g., pretreatment value in a patientbeing treated, or general value observed in a particular patientpopulation) by at least about 10 ng/ml, at least about 100 ng/ml, atleast about 200 ng/ml, at least about 300 ng/ml, at least about 400ng/ml, at least about 500 ng/ml, at least about 600 ng/ml, at leastabout 700 ng/ml, at least about 800 ng/ml, at least about 900 ng/ml, atleast about 1000 ng/ml, at least about 1100 ng/ml, at least about 1200ng/ml, at least about 1300 ng/ml, at least about 1400 ng/ml, at leastabout 1500 ng/ml, at least about 2000 ng/ml, at least about 2500 ng/ml,at least about 3000 ng/ml, at least about 3500 ng/ml, at least about4000 ng/ml, at least about 4500 ng/ml, at least about 5000 ng/ml, atleast about 6000 ng/ml, at least about 7000 ng/ml, at least about 8000ng/ml, at least about 9000 ng/ml, at least about 10000 ng/ml, or morethan 10000 ng/ml.

In some embodiments, the compounds and methods provided herein mayprovide a reduction in serum iron. For example, serum iron may bereduced below a baseline value (e.g., pretreatment value in a patientbeing treated, or general value observed in a particular patientpopulation) by at least about 1 μg/dl, at least about 5 μg/dl, at leastabout 10 μg/dl, at least about 15 μg/dl, at least about 20 μg/dl, atleast about 25 μg/dl, at least about 30 μg/dl, at least about 35 μg/dl,at least about 40 μg/dl, at least about 45 μg/dl, at least about 50μg/dl, at least about 60 μg/dl, at least about 70 μg/dl, at least about80 μg/dl, at least about 90 μg/dl, at least about 100 μg/dl, or morethan 100 μg/dl.

In some embodiments, the compounds and methods provided herein mayprovide a reduction in transferritin saturation. For example,transferritin saturation may be reduced below a baseline value (e.g.,pretreatment value in a patient being treated, or general value observedin a particular patient population) by at least about 5%, 10%, 15%, 20%,25%, 30%, 35%, 40%, 50%, or more than 50%.

In some embodiments, the compounds and methods provided herein mayprovide an increase in serum total adiponectin. For example, serum totaladiponectin may be increased above a baseline value (e.g., pretreatmentvalue in a patient being treated, or general value observed in aparticular patient population) by at least about 10 pmol/ml, at leastabout 50 pmol/ml, at least about 60 pmol/ml, at least about 70 pmol/ml,at least about 80 pmol/ml, at least about 90 pmol/ml, at least about 100pmol/ml, at least about 110 pmol/ml, at least about 120 pmol/ml, atleast about 130 pmol/ml, at least about 140 pmol/ml, at least about 150pmol/ml, at least about 200 pmol/ml, at least about 250 pmol/ml, atleast about 300 pmol/ml, at least about 350 pmol/ml, at least about 400pmol/ml, at least about 450 pmol/ml, at least about 500 pmol/ml, atleast about 550 pmol/ml, at least about 600 pmol/ml, at least about 650pmol/ml, at least about 700 pmol/ml, at least about 750 pmol/ml, atleast about 800 pmol/ml, at least about 850 pmol/ml, at least about 900pmol/ml, at least about 950 pmol/ml, at least about 1000 pmol/ml, ormore than 1000 pmol/ml.

In some embodiments, the compounds and methods provided herein mayprovide a reduction in percent unmodified adiponectin. For example,percent unmodified adiponectin may be reduced below a baseline value(e.g., pretreatment value in a patient being treated, or general valueobserved in a particular patient population) by at least about 1%, atleast about 2%, at least about 3%, at least about 4%, at least about 5%,at least about 6%, at least about 7%, at least about 8%, at least about9%, at least about 10%, at least about 11%, at least about 12%, at leastabout 13%, at least about 14%, at least about 15%, at least about 16%,at least about 17%, at least about 18%, at least about 19%, at leastabout 20%, at least about 21%, at least about 22%, at least about 23%,at least about 24%, at least about 25%, or more than 25%.

In some embodiments, the compounds and methods provided herein mayprovide a reduction in a serum ceramide in proportion to other serumceramides. For example, a percent serum ceramide may be reduced below abaseline value (e.g., pretreatment value in a patient being treated, orgeneral value observed in a particular patient population) by at leastabout 1%, at least about 5%, at least about 10%, at least about 15%, atleast about 20%, at least about 25%, at least about 30%, at least about35%, at least about 40%, at least about 45%, at least about 50%, or morethan 50%.

In some embodiments, the compounds and methods provided herein mayprovide a reduction in a serum sphingosine. For example, a percent serumsphingosine may be reduced below a baseline value (e.g., pretreatmentvalue in a patient being treated, or general value observed in aparticular patient population) by at least about 5%, at least about 10%,at least about 11%, at least about 12%, at least about 13%, at leastabout 14%, at least about 15%, at least about 16%, at least about 17%,at least about 18%, at least about 19%, at least about 20%, at leastabout 25%, at least about 30%, at least about 35%, at least about 40%,at least about 45%, at least about 50%, or more than 50%.

Combination Therapies

In some embodiments, the compounds disclosed herein, such as an oddchain fatty acid, or a salt or derivative thereof, or a pharmaceuticalcomposition that includes a compound described herein, or a salt orderivative thereof, may be used in combination with one or moreadditional active agents. Examples of additional active agents that canbe used in combination with a compound of an odd chain fatty acid, or asalt or derivative thereof, or a composition that includes a compound ofan odd chain fatty acid, or a salt or derivative thereof, include, butare not limited to, agents currently used for treating metabolicsyndrome and related conditions, as described herein and as otherwiseknown to medical science.

In some embodiments, a compound of an odd chain fatty acid, or a salt orderivative thereof, or a composition that includes a compound of an oddchain fatty acid, or a salt or derivative thereof, can be used with one,two, three or more additional active agents described herein. Suchagents include, but are not limited to, a second odd chain fatty acid,or a salt or derivative thereof.

In some embodiments, a compound of an odd chain fatty acid, or a salt orderivative thereof, or a composition that includes a compound of an oddchain fatty acid, or a salt or derivative thereof, can be used (forexample, administered or ingested) in combination with another agent oragents for treatment, prevention, maintenance, or prophylaxis ofmetabolic syndrome, diabetes, and the like, or for modulation of markersof metabolic syndrome. For example, a compound of an odd chain fattyacid disclosed herein can be used in combination with one or more agentsselected from albiglutide, aleglitazar, balaglitazone, canagliflozin,CJ-30001 (CJ Cheiljedang Corporation), CJ-30002 (CJ CheiljedangCorporation), Diamyd® (glutamic acid decarboxylase (rhGAD65)),dulaglutide, exendin 4, gemigliptin, lixisenatide, lobeglitazone,shengke I (Tibet Pharmaceuticals), SK-0403 (Sanwa Kagaku Kenkyusho),teneligliptin, teplizumab, tofogliflozin, acarbose, alogliptin benzoate,chlorpropamide, Diab II (Biotech Holdings), exenatide, glibenclamide,gliclazide, glimepiride, glipizide, gliquidone, glisentide, glisolamide,HL-002 (HanAII Biopharma), insulin (human), insulin, insulin analogue(Eli Lilly®), insulin aspart, insulin detemir, insulin glargine, insulinlispro, Janumet®, linagliptin, liraglutide, metformin, miglitol,mitiglinide, nateglinide, Novo Mix 30® (Novo Nordisk®) pioglitazone,pramlintide, repaglinide, rosiglitazone maleate, saxagliptin,sitagliptin, Tresiba, tolazamide, tolbutamide, vildagliptin, voglibose,bezafibrate, diflunisal, cinnamic acid, carbutamide, glyburide(glibenclamide), glibomuride, glyhexamide, phenbutamide, andtolcyclamide or with one or more agents selected from a class of agents,where the classes include sulfonylureas, non-sulfonylurea secretagogues,glucagon-like peptides, exendin-4 polypeptides, beta 3 adrenoceptoragonists, PPAR agonists, dipeptidyl peptidase IV inhibitors, biguanides,alpha-glucosidase inhibitors, immunomodulators, statins andstatin-containing combinations, angiotensin converting enzymeinhibitors, adeno sine A1 receptor agonists, adenosine A2 receptoragonists, aldosterone antagonists, alpha 1 adrenoceptor antagonists,alpha 2 adrenoceptor agonists, alpha 2 adrenoceptor agonists,angiotensin receptor antagonists, antioxidants, ATPase inhibitors,atrial peptide agonists, beta adrenoceptor antagonists, calcium channelagonists, calcium channel antagonists, diguanides, diuretics, dopamineD1 receptor agonists, endopeptidase inhibitors, endothelin receptorantagonists, guanylate cyclase stimulants, phosphodiderivativease Vinhibitors, protein kinase inhibitors, Cdc2 kinase inhibitors, renininhibitors, thromboxane synthase inhibitors, vasopeptidase inhibitors,vasopressin I antagonists, vasopressm 2 antagonists, angiogenesisinhibitors, advanced glycation end product inhibitors, bile acid bindingagents, bile acid transport inhibitors, bone formation stimulants,apolipoprotein A1 agonists, DNA topoisomerase inhibitors, cholesterolabsorption inhibitors, cholesterol antagonists, cholderivativeylderivative transfer protein antagonists, cytokine synthesis inhibitors,DNA polymerase inhibitors, dopamine D2 receptor agonists, endothelinreceptor antagonists, growth hormone antagonists, insulin sensitizers,lipase inhibitors, lipid peroxidation inhibitors, lipoprotein Aantagonists, microsomal transport protein inhibitors, microsomaltriglyceride transfer protein inhibitors, nitric oxide synthaseinhibitors, oxidizing agents, phospholipase A2 inhibitors, radicalformation agonists, platelet aggregation antagonists, prostaglandinsynthase stimulants, reverse cholesterol transport activators, rhokinase inhibitors, selective estrogen receptor modulators, squaleneepoxidase inhibitors, squalene synthase inhibitors, thromboxane A2antagonists, amylin agonists, cannabinoid receptor antagonists,cholecystokinin A agonists, corticotropin-releasing factor agonists,dopamine uptake inhibitors, G protein-coupled receptor modulators,glutamate antagonists, glucagon-like peptide-1 agonists lipaseinhibitors, melanin-concentrating hormone receptor antagonists, nervegrowth factor agonists, neuropeptide Y agonists, neuropeptide Yantagonists, SNRIs, protein tyrosine phosphatase inhibitors, serotonin2C receptor agonists, or with other agents such as central nervoussystem agents that affect neurotransmitters or neural ion channels,including antidepressants (bupropion), noradrenalin reuptake inhibitors(GW320659), selective serotonin 2c receptor agonists, selective 5HT 2creceptor agonists, antiseizure agents (topiramate, zonisamide), dopamineantagonists, cannabinoid-1 receptor antagonists (CB-1 receptorantagonists) (rimonabant); leptin/insulin/central nervous system pathwayagents, including leptin analogues, leptin transport and/or leptinreceptor promoters, ciliary neurotrophic factor (Axokine), neuropeptideY and agouti-related peptide antagonists, pro-opiomelanocortin andcocame and amphetamine regulated transcript promoters,a-melanocyte-stimulating hormone analogues, melanocoritin-4 receptoragonists, and agents that affect insulin metabolism/activity, whichinclude protein-tyrosine phosphatase-IB inhibitors, peroxisomeproliferator activated receptor-.gamma. receptor antagonists,short-acting bromocriptine (ergoset), somatostatin agonists(octreotide), and adiponectin/Acrp30 (Famoxin or Fatty Acid MetabolicOxidation Inducer); gastrointestinal-neural pathway agents, includingthose that increase cholecystokinin activity (CCK), PYY activity, NPYactivity, and PP activity, increase glucagon-like peptide-1 activity(exendin 4, dipeptidyl peptidase IV inhibitors), and those that decreaseghrelin activity, as well as amylin analogues (pramlintide); agents thatmay increase resting metabolic rate (selective (3-3 stimulators/agonist,uncoupling protein homologues, and thyroid receptor agonists); othermore diverse agents, including melanin concentrating hormoneantagonists, phytostanol analogues, functional oils, P57, amylaseinhibitors, growth hormone fragments, synthetic analogues ofdehydroepiandrosterone sulfate, antagonists of adipocyte11B-hydroxysteroid dehydrogenase type I activity,corticotropin-releasing hormone agonists, inhibitors of fatty acidsynthesis (cerulenin and C75), carboxypeptidase inhibitors,indanone/indanols, aminosterols (trodusquemine/trodulamine), and othergastrointestinal lipase inhibitors (ATL962); amphetamines, such asdextroamphetamine; other sympathomimetic adrenergic agents, includingphentermine, benzphetamine, phendimetrazine, mazindol, anddiethylpropion; or with one or more agents selected from ecopipam;oxyntomodulin (OM); inhibitors of glucose-dependent insulinotropicpolypeptide (GIP); gastrin-releasing peptide; neuromedin B;enterostatin; amfebutamone, SR-58611; CP-045598; AOD-0604; QC-BT16;rGLP-1; 1426 (HMR-1 426); N-5984; ISIS-1 13715; solabegron; SR-1 47778;Org-34517; melanotan-II; cetilistat; c-2735; c-5093; c-2624; APD-356;radafaxine; fluasterone; GP-389255; 856464; S-2367; AVE-1625; T-71;oleoyl-estrone; peptide YY [3-36] intranasal; androgen receptoragonists; PYY 3-36; DOV-I 02677; tagatose; SLV-3 I 9; I 954 (AventisPharma AG); oxyntomodulin, Thiakis; bromocriptine, PLIVA;diabetes/hyperlipidemia therapy, Yissum; CKD-502; thyroid receptor betaagonists; beta-3 adrenoceptor agonist; CDK-A agonists; galaninantagonist; dopamine D I D2 agonists; melanocortin modulators;verongamme; neuropeptide Y antagonists; melanin-concentrating hormonereceptor antagonists; dual PPAR alpha/gamma agonists; CGEN-P-4; kinaseinhibitors; human MCH receptor antagonists; GHS-R antagonists; ghrelinreceptor agonists; DG70 inhibitors; cotinine; CRF-BP inhibitors;urocortin agonists; UCL-2000; impentamine; f3-3 adrenergic receptor;pentapeptide MC4 agonists; trodusquemine; GT-20 16; C-75; CPOP; MCH-1receptor antagonists; RED-1 03004; aminosterols; orexin-1 antagonists;neuropeptide Y5 receptor antagonists; DRF-4158; PT-15; PTPaseinhibitors; A372 I 5; SA-0204; glycolipid metabolites; MC-4 agonist;produlestan; PTP-1B inhibitors; GT-2394; neuropeptide Y5 antagonists;melanocortin receptor modulators; MLN-4760; PPAR gamma/delta dualagonists; NPYSRA-972; 5-HT2C receptor agonist; neuropeptide Y5 receptorantagonists (phenyl urea analogs); AGRP/MC4 antagonists; neuropeptide Y5antagonists (benzimidazole); glucocorticoid antagonists; MCHR 1antagonists; Acetyl-CoA carboxylase inhibitors; R-1496; HOB 1modulators; NOX-B11; peptide YY 3-36 (eligen); 5-HT 1 modulators;pancreatic lipase inhibitors; GRC-1087; CB-1 antagonists; MCH-1antagonists; LY-448100; bombesin BRS3 agonists; ghrelin antagonists; MC4antagonists; stearoyl-CoA desaturase modulators; PPAR pan agonists;EP-01492; hormone-sensitive lipase inhibitors; fatty acid-bindingprotein 4 inhibitors; thiolactone derivatives; protein tyrosinephosphatase IB inhibitors; MCH-1 antagonist; P-64; PPAR gamma ligands;melanin concentrating hormone antagonists; thiazole gastroprokinetics;PA-452; T-226296; A-331440; immunodrug vaccines; diabetes % besitytherapeutics (Bioagency, Biofrontera Discovery GmbH); P-7 (Genfit);DT-011 M; PTP1B inhibitor; anti-diabetic peptide conjugates; KATPagonists; obesity therapeutics (Lexicon); 5-HT2 agonists; MCH-1 receptorantagonists; GlYIAD-1/GMAD-2; STG-a-MD; angiogenesis inhibitors; Gprotein-coupled receptor agonists; nicotinic therapeutics (ChemGenex);anti-obesity agents (Abbott); melanin concentrating hormone; GW-594884A;MC-4R agonist; histamine H3 antagonists; orphan GPCR modulators;MITO-3108; NLC-002; HE-2300; IGF/BBP-2-13; 5-HT2C agonists; ML-22952;neuropeptide Y receptor antagonists; AZ-40140; anti-obesity therapy(Nisshin Flour); GNTI; melanocortin receptor modulators; alpha-amylaseinhibitors; beta-3 adrenoceptor agonists; ob gene products (Eli Lilly &Co.); SWR-0342-SA; SWR-0335; SP-18904; oral insulin mimetics; obesitytherapeutics (7TM Pharma); beta-hydroxysteroid dehydrogenase (HSD)inhibitors; QRX-431; E-6776; RI-450; melanocortin-4 antagonists;melanocortin 4 receptor agonists; obesity therapeutics (CuraGen); leptinmimetics; A-74498; second-generation leptin; NBI-103; CL-314698;CP-114271; beta-3 adrenoceptor agonists; NMI-8739; UCL-1283; BMS-192548;CP-94253; PD-160170; nicotinic agonist; LG-100754; SB-226552; LY-355124;CKD-711; L-751250; PPAR inhibitors; G-protein therapeutics; obesitytherapy (Amylin Pharmaceuticals Inc.); BW-1229; monoclonal antibody(ObeSys/CAT); L-742791; (S)-sibutramine; MBU-23; YM-268; BTS-78050;tubby-like protein genes; genomics (eating disorders; Allelix/Lilly);MS-706; GI-264879A; GW-409890; FR-79620 analogs; obesity therapy(Hybrigenics SA); ICI-198157; ESP-A; 5-HT2C agonists; PD-170292;AIT-202; LG-100641; GI-181771; anti-obesity therapeutics (Genzyme);leptin modulator; GHRH mimetics; obesity therapy (YamanouchiPharmaceutical Co. Ltd.); SB-251023; CP-331684; BIB0-3304;cholesten-3-ones; LY-362884; BRL-48962; PY-1 antagonists; A-71378;.RTM.-didesmethylsibutramine; obesity therapeutics (Bristol-Myers SquibbCo.); obesity therapeutics (Ligand Pharmaceuticals Inc.); LY-226936; NPYantagonists; CCK-A agonists; FPL-14294; PD-145942; ZA-7114; CL-316243;SR-58878; R-1065; BDBP-3226; HP-228; talibegron; FR-165914; AZM-008;AZM-016; AZM-120; AZM-090; AZM-131; AZM-132; AZM-134; AZM-127; AZM-083;AZM-115; AZM-140; vomeropherin; BMS-187257; D-3800; gene discovery(Axys/Glaxo); BRL-26830A; SX-013; ERR modulators; adipsin; AC-253;A-71623; A-68552; BMS-210285; TAK-677; MPV-1743; obesity therapeutics(Modex); GI-248573; exopipam; SSR-125180; obesity therapeutics (MelacureTherapeutics AB); BRL-35135; SR-146131; P-57; CGP-71583A; RF-1051;BMS-196085; manifaxine; DMNJ (Korea Research Institute of Bioscience andBiotechnology); BVT-5182; LY-255582; SNX-024; galanin antagonists;neurokinin-3 antagonists; dexfentluramine; mazindol; diethylpropion;phendimetrazine; benzphetamine; amfebutmone; sertraline; AOD-9604;ATL-062; BVT-933; GT389-255; SLV319; HE-2500; PEG-axokine; L-796568; andABT-239; rimonabant, sibutramine, orlistat, PYY or an analog thereof,CB-1 antagonist, leptin, phentermine, and exendin analogs; GPR 1 19agonists (e.g., anandamide; AR-231, 453; MBX-2982; Oleoylethanolamide;PSN-365,963; PSN-632,408; palmitoylethanolamide); GPR120 agonists; GPR40 agonists; SGLT2 inhibitors.

Dosing

As will be readily apparent to one skilled in the art, the useful invivo dosage to be administered and the particular mode of administrationwill vary depending upon the age, weight, the severity of the condition,and mammalian species treated, the particular forms of the compoundsemployed, and the specific use for which these compounds are employed.The determination of effective dosage levels, that is the dosage levelsnecessary to achieve the desired result, can be accomplished by oneskilled in the art using routine methods, for example, in vivo studies.Reference may be made to, for example, “Estimating the Maximum SafeStarting Dose in Initial Clinical Trials for Therapeutics in AdultHealthy Volunteers,” U.S. Food and Drug Administration, July 2005.

In some embodiments, a method provided herein may comprise administeringa therapeutically effective amount of a composition provided herein. Insome embodiments, a therapeutically effective amount may be determinedby reference to the modulation of a marker of metabolic syndrome. Insome embodiments, a therapeutically effective amount may be determinedby reference to the modulation of a symptom of metabolic syndrome. Instill other embodiments, reference may be made to established guidelinesfor the conditions described herein, including, but not limited to,guidelines for the treatment of diabetes.

The dosage may vary broadly, depending upon the desired effects and thetherapeutic indication, such as marker values. Alternatively, dosagesmay be based and calculated upon the surface area or weight of thepatient, as understood by those of skill in the art. The exact dosagewill be determined on a case-by-case basis, or, in some cases, will beleft to the informed discretion of the subject. The daily dosage regimenfor an adult human patient may be, for example, an oral dose of an oddchain fatty acid, or a salt or derivative thereof, or a mixture of aplurality of odd chain fatty acids, or a salt or derivative thereof,from about 0.01 mg to about 10000 mg, from about 1 mg to about 5000 mg,from about 5 mg to about 2000 mg, from about 10 mg to about 1000 mg, orfrom about 50 mg to about 500 mg. A single dose may include an odd chainfatty acid, or a salt or derivative thereof, in about 0.01 mg, about 0.1mg, about 1 mg, about 5 mg, about 10 mg, about 20 mg, about 50 mg, about100 mg, about 200 mg, about 300 mg, about 400 mg, about 500 mg, about600 mg, about 800 mg, about 900 mg, about 1000 mg, about 2000 mg, about5000 mg, or more. The dosage may be adjusted according to the body massof the subject, for example, the dosage may be about 0.001 mg/kg, about0.01 mg/kg, about 0.1 mg/kg, about 0.5 mg/kg, about 1 mg/kg, about 2mg/kg, about 3 mg/kg, about 4 mg/kg, about 5 mg/kg, about 6 mg/kg, about7 mg/kg, about 8 mg/kg, about 9 mg/kg, about 10 mg/kg, about 15 mg/kg,about 20 mg/kg, about 25 mg/kg, about 30 mg/kg, or higher. The dosagemay be a single one or a series of two or more given in the course ofone or more days, as is appropriate for the individual subject. In someembodiments, the compounds will be administered for a period ofcontinuous therapy, for example for about a week or more (e.g., oneweek, two weeks, three weeks, four weeks, five weeks, six weeks, sevenweeks, eight weeks, or more), for several weeks, for about a month ormore (e.g., one month, two months, three months, four months, fivemonths, six months, seven months, eight months, nine months, ten months,eleven months, twelve months, or more), for about a year or more, or fora plurality of years. In some embodiments, an odd chain fatty acid, or asalt or derivative thereof, can be administered or ingested one time perday, two times per day, three times per day, or more.

As will be understood by those of skill in the art, in certainsituations it may be necessary to administer the compounds disclosedherein in amounts that exceed the above-stated, preferred dosage rangein order to effectively treat a subject.

Unit dosage forms can also be provided, e.g., individual packages with apremeasured amount of the composition, configured for administration ona predetermined schedule. Unit dosage forms configured foradministration one to three times a day are preferred; however, incertain embodiments it may be desirable to configure the unit dosageform for administration more than three times a day, or less than onetime per day.

Dosage amount and interval may be adjusted to the individual subject toprovide plasma levels of the active moiety which are sufficient tomaintain predetermined parameters, indicators, or marker values, orminimal effective concentration (MEC). Dosages necessary to achieve thedesired result will depend on individual characteristics and route ofadministration. However, assays, for example, HPLC assays or bioassays,may be used to determine serum concentrations.

In some embodiments, the compounds and methods provided herein may beused in conjunction with devices and methods of using devices, forexample, as provided in U.S. Pat. No. 7,651,845; U.S. Pat. No.8,251,904; U.S. Pat. No. 8,251,904; U.S. Pat. No. 4,985,015; U.S. Pat.No. 8,827,957; U.S. Pat. No. 4,252,159; U.S. Pat. No. 5,318,521; U.S.Pat. No. 4,718,430; U.S. 2011/0190702; DE2615061; and in conjunctionwith diagnostic devices, for example, as provided in U.S. 2012/0072236.

Diagnosis and Monitoring

Provided herein are methods for the diagnosis and monitoring ofmetabolic syndrome and related conditions.

In some embodiments, the method of diagnosis or monitoring may comprisethe step of measuring percentage of an odd chain fatty acid. In someembodiments, the method of diagnosis or monitoring may comprise the stepof measuring a marker of metabolic syndrome. In some embodiments, acorrelation between one marker and another may prove instructive. Insome embodiments, metabolic syndrome or a related condition may bediagnosed by reference to a threshold level of a marker of metabolicsyndrome, for example, serum odd chain fatty acid percentage, serumconcentration of an odd chain fatty acid, or serum total odd chain fattyacid. For example, the threshold may be determined by reference to asymptom or marker of metabolic syndrome or a related condition, forexample, diabetes.

The percentage of an odd chain fatty acid, or a marker of metabolicsyndrome, in a subject may be monitored by any means. Samples foranalysis may be derived any fluid or tissue of the subject. For example,from serum, plasma, erythrocyte membranes, urine, and feces.

Example 1: Dolphin Study

Dolphins at the Navy Marine Mammal Program (MMP) are a well-studieddolphin population with regard to metabolic syndrome, and thispopulation has a higher risk of developing metabolic syndrome whencompared to wild dolphins, such as wild dolphins living in Sarasota Bay,Fla., for example. When comparing the two populations, neither body massindices nor stress indices (i.e., cortisol) are risk factors formetabolic syndrome in MMP dolphins. In studies comparing values ofblood-based indicators of metabolic syndrome, MMP dolphins have beenolder than Sarasota Bay dolphins; older age of the MMP dolphinpopulation is further supported by its higher annual survival rates andlonger lives compared to wild dolphins, including those living inSarasota Bay. Proposed risk factors for metabolic syndrome in dolphinscan include advanced age, differences in feeding and activity schedules,and differences in dietary fish. It can be hypothesized that differencesin dietary fish (and certain fatty acids associated with particulartypes of fish) can be responsible for differences in the risk ofmetabolic syndrome and iron overload in dolphins.

This study examined global metabolic profiles in six dolphins (“Group Adolphins”). The dolphins lived in netted enclosures within San DiegoBay. The dolphins started on a 100% capelin diet. Group A dolphins werefed one-third of their daily diet in the morning after their routineovernight fast and 2 h postprandial, in-water, and trained blood sampleswere drawn (typically near 10:00 a.m.). An additional four dolphins(“Group C dolphins”) were fed the capelin diet.

Capelin, the primary fish type fed to Group C dolphins, had nodetectable C17:0 (<0.007 g/100 g). For other fish, C17:0 was measured asfollows: croaker=39 mg/100 g, pinfish=41 mg/100 g, mullet=67 mg/100 g,herring=19 mg/100 g, and mackerel=22 mg/100 g. There was no detectable C17:0 in squid.

The diets of the six Group A dolphins were from a capelin diet totransitioned to a diet consisting of 25% capelin, 25% mullet, 25%croaker, and 25% pinfish, while maintaining the same kilocalories.Comparisons of daily fatty acid intake of the dolphins' original andmodified diets are provided (Table 3), including demonstrated increasedintake of C17:0 from a daily mean of 400 to 1,700 mg (greater than afour-fold increase).

Wild Sarasota Bay dolphins (“Group B dolphins”) were analyzed as areference group. While the timing of the most recent meal prior to eachGroup B dolphin's capture release was unknown, sonography was used toassess the presence or absence of stomach contents. Group B dolphins inthe study had contents in their stomachs, supporting they were in apostprandial state. Following sample collection, Group B dolphins werereleased on site.

Two hour post-prandial samples were collected from the dolphins atbaseline (week 0) and at four time points following the switch to themodified diet: 6, 12, 18, and 24 weeks. Routine monthly samplescollected from four reference dolphins that were housed in the sameenvironment as the Group A dolphins were assessed for glucose,triglycerides, ferritin, and percent serum fatty acids.

Changes in percent serum for the targeted fatty acids (C17:0, C20:4n6,and C22:0), as well as insulin, glucose, triglycerides, iron,transferrin saturation, and ferritin, were assessed among feeding studydolphins during weeks 3, 6, 12, 18 and 24 and compared to week 0 usingpairwise comparison t-tests. Erythrocyte membrane fatty acids weremeasured during weeks 3, 6, 12, 18, and 24. Outcomes for markers ofmetabolic syndrome for Group A dolphins are provided in Table 4. Serumferritin in Group A dolphins increased. Outcomes for markers ofmetabolic syndrome for the Group C dolphin group are provided in Table5.

When a modified diet adding 25% pinfish and/or mullet was fed to sixGroup A dolphins over 24 weeks (increasing the average daily dietaryC17:0 intake from 400 to 1700 mg), C17:0 serum levels increased, highferritin decreased, and blood-based metabolic syndrome indicesnormalized toward reference levels. These effects were not found inGroup C dolphins. Further, higher total serum C17:0 was an independentpredictor of lower ferritin in dolphins in Group B dolphins.

Group A dolphins had a decrease in measures of spread (normalization)for triglycerides, glucose, and insulin that trended consistently fromweeks 0 to 24. The standard deviation for glucose and triglyceridesdecreased from 23 to 6 mg/dl and 81 to 21 mg/dl, respectively. Incomparison, Group C dolphins had an increase in standard deviation fromweeks 0 to 24 (glucose increased from 12 to 14, and triglyceridesincreased from 20 to 98). The coefficient of variation (C.V.) from week0 to week 24 for Group A dolphins decreased from 22% to 6% for glucoseand 61% to 24% for triglycerides. When limiting to five study Group Adolphins (excluding the outlier sixth male dolphin that maintained highinsulin possibly due to rut behavior and associated high testosteronethroughout the study), the insulin standard deviation for dolphins onthe modified diet decreased dramatically from 18 to 3 μIU/ml. Whenlimiting to five study Group A dolphins (excluding the sixth dolphinthat was experiencing rut behavior), the insulin C.V. decreased from100% to 38%.

Serum ferritin levels decreased in all six Group A dolphins, with weeks3 through 24 having lower levels than week 0. Total serum C17:0 (P=0.02)was associated with serum ferritin. Total serum C17:0 (R2=0.29, P=0.02)had an inverse relationship with ferritin. Stepwise regression,including age as a covariate, demonstrated that total serum C17:0 was anindependent predictor of serum ferritin in dolphins (P=0.02) (Table 6).Indices of acute inflammation (ceruloplasmin and haptoglobin) wereassessed. Despite decreases in ferritin, there were no differences inthese two proteins during any of the study weeks compared to week 0,supporting that decreased ferritin was likely not due to changes inacute inflammation.

Fatty acids were compared between the two dolphin populations. Higher(n=30, Group A) and lower (n=19, Group B) mean insulin (11±12 and 2±5μIU/ml, respectively; P<0.0001) and their dietary fish. In addition tohigher insulin, triglycerides, and ferritin, Group A had lower percentserum heptadecanoic acid (C17:0) compared to Group B (0.3±0.1 and1.3±0.4%, respectively; P<0.0001).

Group A dolphins also exhibited increased serum concentrations of otherodd-chain fatty acids. Pelargonate, 10-undecenoate, nonadecanoate,arachidonate, adrenate, and docosapentaenoate were measured (Table 1).

Sample Collection and Transport

Blood was collected into BD Vacutainer serum separator tubes (forinsulin, iron, ferritin, serum fatty acids profile, and serumchemistry), EDTA BD Vacutainer blood collection tubes (for erythrocytefatty acid profile), and Lithium Heparin BD Vacutainer blood collectiontubes (for plasma chemistry, including triglycerides). Blood tubes werecentrifuged at 3000 rpm for 10 minutes within 30-60 minutes ofcollection and chilled during processing until shipment. Remainingserum/plasma was transferred to cryovials and stored at −80° C. untilshipment on dry ice via overnight courier to the reference laboratories.

Sample Analysis

Serum and red blood cell membrane fatty acid profiles were performed bythe Genetics Laboratories at the Kennedy Krieger Institute. Fatty acidswere analyzed by capillary gas chromatography/mass spectrometry ofpentaflourobenzyl bromide fatty acid derivatives using an AT-Silar-100column (Grace, Columbia, Md. 21044) as previously described. For redblood cells only, the lipids were extracted with hexane:isopropanolbefore analysis. Each run was required to pass clinical laboratoryquality control before the data were released. CV % were typically under10%. Percent fatty acids in serum was used as a sturdier index to helpreduce potential variability in serum among study dolphins. Iron, TIBC,and ferritin were analyzed at the Kansas State Veterinary DiagnosticLaboratory by colorimetric analysis on the Roche Cobas Mira (RocheDiagnostics, Indianapolis, Ind. 46250) per the manufacturer's protocol.Plasma triglycerides and glucose were directly measured using the RocheCobas 8000 system (Roche Diagnostics, Indianapolis, Ind. 46250) per themanufacturers' protocol. Glucose was measured photometrically at theAnimal Health Diagnostic Center at Cornell University on the RocheDiagnostics Modular Analytics P Module clinical chemistry analyzer(Roche Diagnostics, Indianapolis, Ind. 46250). Total insulin wasanalyzed at ARUP Laboratories by ultrafiltration/quantitativechemiluminescent immunoassay on the Siemens ADVIA Centaur Immunoassaysystem (Siemens Medical Solutions USA, Inc., Malvern, Pa. 19355).

Statistical analyses were conducted using World Programming Systemsoftware (World Programming Ltd., Hampshire, United Kingdom). A generallinear model was used to test for associations between insulin and 55individual serum fatty acids. The 31 (56%) fatty acids that wereassociated with insulin were included in a multivariate, stepwiseregression model to determine independent predictors of insulin. Amongthe six (11%) fatty acids that were independent predictors of insulin, aWilcoxon rank-sum test was used to compare fatty acid levels betweenGroup A and Group B dolphins; three (5%) of the six fatty acid had lowerlevels in Group A compared to Group B dolphins. To identify potentiallylow fish-based fatty acids that may be corrected through a modifieddiet, the term, ‘targeted dietary fatty acids’ for the remaining studywas defined as fatty acids that were independent predictors of insulinand had significantly lower levels in Group A dolphins compared to GroupB dolphins. Significance was defined as a P value less than 0.05.

Comparisons of glucose, triglycerides, iron, transferrin saturation,ferritin, and targeted percent serum fatty acids controlled for age byusing an analysis of covariance with age as a covariate. Fish fatty acidprofiles and iron measurements were performed by Covance Laboratories(Madison, Wis. 53703). Each of the following fish types was mixed withwater and homogenized for uniformity: capelin from Canada and Iceland(Mallotus villosus), Atlantic croaker (Micropogonias undulatus), herring(Clupea harengus), mackerel (Scomber japonicus), pinfish (Lagodonrhomboides), squid (Loligo opalescens), and striped mullet (Mugilcephalus). The lipid was extracted, saponified with 0.5N methanolicsodium hydroxide, and methylated with 14% BF3-methanol. The resultingmethyl derivatives of the fatty acids were extracted with heptane. Aninternal standard was added prior to the lipid extraction. The methylderivatives of the fatty acids were analyzed by gas chromatography usingexternal standards for quantitation.

Iron was measured by ICP Emission Spectrometry according to the OfficialMethods of Analysis of AOAC INTERNATIONAL, 18th Ed., Method 984.27 and985.01, AOAC INTERNATIONAL, Gaithersburg, Md., USA, (2005). (Modified)(Covance, Madison, Wis. 53703).

Measurement of Serum Fatty Acids and Metabolites

Sample Accessioning: All samples were maintained at −80° C. untilprocessed.

Sample Preparation: Samples were prepared using the automated MicroLabSTAR® system from Hamilton Company. Several recovery standards wereadded prior to the first step in the extraction process for QC purposes.Proteins were precipitated with methanol under vigorous shaking for 2min (Glen Mills GenoGrinder 2000) followed by centrifugation. Theresulting extract was divided into five fractions: two for analysis bytwo separate reverse phase (RP)/UPLC-MS/MS methods with positive ionmode electrospray ionization (ESI), one for analysis by RP/UPLC-MS/MSwith negative ion mode ESI, one for analysis by HILIC/UPLC-MS/MS withnegative ion mode ESI, and onesample was reserved. Samples were placedbriefly on a TurboVap® (Zymark) to remove the organic solvent. Thesample extracts were stored overnight under nitrogen before preparationfor analysis.

QA/AC: First, a pooled matrix sample generated by taking a small volumeof each experimental sample (or alternatively, use of awell-characterized human plasma) served as a technical replicatethroughout the data set; Second, extracted water samples served asprocess blanks; third, instrument variability was determined bycalculating the median relative standard deviation (RSD) for thestandards that were added to each sample prior to injection into themass spectrometers; fourth, experimental samples were randomized acrossthe platform run with QC samples spaced evenly among the injections.

Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy(UPLC-MS/JVIS): Each of four methods utilized a Waters ACQUITYultra-performance liquid chromatography (UPLC) and a Thermo ScientificQ-Exactive high resolution/accurate mass spectrometer interfaced with aheated electrospray ionization (HESI-II) source and Orbitrap massanalyzer operated at 35,000 mass resolution. A sample extract was dried,then reconstituted in solvents compatible to each of the four methods.Each reconstitution solvent contained a series of standards at fixedconcentrations to ensure injection and chromatographic consistency. Afirst aliquot was analyzed using acidic positive ion conditions,chromatographically optimized for more hydrophilic compounds. In thismethod, the extract was gradient eluted from a C18 column (Waters UPLCBEH C18-2.1×100 mm, 1.7 μm) using water and methanol, containing 0.05%perfluoropentanoic acid (PFPA) and 0.1% formic acid (FA). A secondaliquot was also analyzed using acidic positive ion conditions, howeverit was chromatographically optimized for more hydrophobic compounds. Inthis method, the extract was gradient eluted from the same aforementioned C18 column using methanol, acetonitrile, water, 0.05% PFPA and0.01% FA and was operated at an overall higher organic content. A thirdaliquot was analyzed using basic negative ion optimized conditions usinga separate dedicated C 18 column. The basic extracts were gradienteluted from the column using methanol and water, however with 6.5 mMAmmonium Bicarbonate at pH 8. A fourth aliquot was analyzed via negativeionization following elution from a HILIC column (Waters UPLC BEH Amide2.1×150 mm, 1.7 μm) using a gradient consisting of water andacetonitrile with 10 mM Ammonium Formate, pH 10.8. The MS analysisalternated between MS and data-dependent MSn scans using dynamicexclusion. The scan range varied slighted between methods but covered70-1000 m/z.

Bioinformatics: The informatics system consisted of four majorcomponents, the Laboratory Information Management System (LIMS), thedata extraction and peak-identification software, data processing toolsfor QC and compound identification, and a collection of informationinterpretation and visualization tools for use by data analysts. Thehardware and software foundations for these informatics components werethe LAN backbone, and a database server running Oracle 10.2.0.1Enterprise Edition.

Data Extraction and Compound Identification: Raw data was extracted,peak-identified and QC processed using Metabolon's hardware andsoftware. The systems were based on a web-service platform utilizingMicrosoft's .NET technologies, which ran on high-performance applicationservers and fiber-channel storage arrays in clusters to provide activefailover and load-balancing. Compounds were identified by comparison tolibrary entries of purified standards or recurrent unknown entities.Biochemical identifications were based on three criteria: retentionindex within a narrow RI window of the proposed identification, accuratemass match to the library+/−10 ppm, and the MS/MS forward and reversescores between the experimental data and authentic standards. The MS/MSscores were based on a comparison of the ions present in theexperimental spectrum to the ions cataloged in a library. The use ofthree data points was utilized to distinguish and differentiatebiochemicals.

Curation: Metabolon proprietary visualization and interpretationsoftware was used to confirm the consistency of peak identificationamong the various samples. Library matches for each compound werechecked for each sample and corrected if necessary.

Metabolite Quantification and Data Normalization: Peaks were quantifiedusing area-under-the-curve. A data normalization step was performed tocorrect variation resulting from instrument inter-day tuningdifferences. Each compound was corrected in run-day blocks byregistering the medians to equal one (1.00) and normalizing each datapoint proportionately (termed “block correction”). For studies that didnot require more than one day of analysis, no normalization was used,other than for purposes of data visualization. Biochemical data wasnormalized to an additional factor (e.g., cell counts, total protein asdetermined by Bradford assay, osmolality, etc.) when necessary, toaccount for differences in metabolite levels due to differences in theamount of material present in each sample. Table 1 provides serumconcentrations for various fatty acids in Group A dolphins at 6, 12, 18,and 24 weeks of the study of Example 1 proportional to values measuredat the outset of the study.

TABLE 1 6 wk 12 wk 18 wk 24 wk Sub Pathway Biochemical Name 0 wk 0 wk 0wk 0 wk Medium Chain caproate (6:0) 0.98 1.01 0.92 0.76 Fatty Acidheptanoate (7:0) 1.42 1.02 1.23 1.21 caprylate (8:0) 1.1 1.07 0.96 1.12perlargonate (9:0) 1.26 1.14 1.56 1.41 10-undecenoate (11:1n1) 1.41 1.541.22 1.75 5-dodecenoate (12:1n7) 1.49 1.67 1.08 1.11 Long Chain Fattymyristate (14:0) 0.8 0.87 0.74 0.58 Acid myristoleate (14:1n5) 1.45 1.550.97 1.02 pentadecanoate (15:0) 1.01 1.27 1.42 0.97 palmitoleate(16:1n7) 0.85 0.99 0.76 0.54 margarate (17:0) 1.25 1.65 1.72 1.2110-heptadecenoate (17:1n7) 1.12 1.38 1.35 0.87 nonadecanoate (19:0) 1.221.65 1.79 1.28 10-nonadecenoate (19:1n9) 1.05 1.28 1.17 0.8 eicosenoate(20:1) 0.72 0.81 0.72 0.43 erucate (22:1n9) 0.71 0.81 0.68 0.45nervonate (24:1n9)* 0.71 1.41 0.74 0.62 oleate/vaccenate (18:1) 0.981.04 0.84 0.64 Polyunsaturated stearidonate (18:4n3) 1.03 0.71 0.61 0.58Fatty Acid eicosapentaenoate (EPA; 20:5n3) 0.88 0.99 0.88 0.57docosapentaenoate (n3 DPA; 22:5n3) 1.13 1.37 1.27 0.78 docosahexaenoate(DHA; 22:6n3) 1.05 1.23 1.06 0.74 docosatrienoate (22:3n3) 1.08 2.061.96 1.06 linoleate (18:2n6) 0.87 0.93 0.76 0.66 linolenate [alpha orgamma; (18:3n3or 6)] 1.13 1.1 0.97 0.98 dihomo-linolenate (20:3n3 or n6)1.14 1.37 1.36 1.03 arachidonate (20:4n6) 1.19 1.62 1.5 1.19 adrenate(22:4n6) 1.51 2.17 2.82 1.73 docosapentaenoate (n6 DPA; 22:5n6) 1.68 2.52.33 2.09 docosadienoate (22:2n6) 0.85 1.08 0.99 0.54 dihomo-linoleate(20:2n6) 0.9 1.12 1.03 0.73

Table 2 provides comparisons of demographics, metabolic healthindicators, and targeted serum fatty acids between Group A dolphins andGroup B dolphins of Example 1. The comparisons of metabolic variablesand targeted serum fatty acids are controlled for age.

TABLE 2 Demographic or Group A blood-based Variable (n = 30) Group B (n= 19) P value Age (years) 26 ± 12 13 ± 9  0.002 Sex (% females) 15 (50%)12 (63%) 0.37 Metabolic variable Insulin (μIU/ml) 11 ± 12 2 ± 5 0.04Serum glucose (mg/di) 104 ± 15  117 ± 10  0.02 Triglycerides (mg/di) 149± 59  78 ± 26 <0.0001 Ferritin (ng/ml) 3,878 ± 3,754 219 ± 184 0.005Iron (μg/di) 177 ± 57  109 ± 48  0.0003 Transferrin saturation (%) 56 ±20 33 ± 11 <0.0001 Targeted serum Fatty acid Cl 7:0 0.3 ± 0.1 1.3 ± 0.4<0.0001 C20:4n6 4.1 ± 1.0 17.4 ± 2.3  <0.0001 C22:0  0.2 ± 0.04 0.7 ±0.2 <0.0001

Table 3 provides comparisons of dietary fatty acid (g) intake betweenoriginal and modified diets for Group A dolphins of Example 1.

TABLE 3 Original Modified diet-total diet-total Fish-based nutrientdaily intake daily intake P value Targeted fatty acids (g) Heptadecanoicacid (Cl7:0) 0.4 ± 0.2 1.7 ± 0.5 0.006 Arachidonic acid (20:4n6) 2 ± 1 5± 2 0.006 Behenic acid (C22:0) 0.2 ± 0.1 0.3 ± 0.3 0.43 Other fattyacids (g) Myristic acid (C14:0) 22 ± 6  18 ± 5  0.23 Pentadecanoic acid(C15:0)   1 ± 0.4 5 ± 4 0.007 Palmitic acid (C16:0) 62 ± 22 67 ± 22 0.71Stearic acid (C18:0) 8 ± 3 12 ± 3  0.03 Oleic acid (C18:1 n9) 55 ± 25 50± 30 0.79 Linoleic acid (C18:2) 7 ± 2 6 ± 2 0.37 Linolenic acid (C18:3)0.8 ± 0.5 1.5 ± 0.4 0.04 Gamma-linolenic (C18:3n3) 0.2 ± 0.1 0.6 ± 0.50.16 Arachidic acid (C20:0) 0.3 ± 0.2 0.7 ± 0.4 0.32 Eicosadienoic acid(C20:2n6) 0.3 ± 0.1 0.5 ± 0.2 0.14 Eicosapentaenoic acid (20:5n3) 40 ±13 35 ± 11 0.43 Erucic acid (C22:1n9) 6 ± 1 3 ± 1 0.006 Docosapentaenoicacid 4 ± 1 6 ± 1 0.009 (C22:5n6) Docosahexaenoic acid 38 ± 10 42 ± 110.63 (C22:6n3) Lignoceric acid (C23:0) 0 0.2 ± 0.1 0.005 Omega 3 fattyacids 86 ± 25 89 ± 22 0.79 Omega 6 fatty acids 9 ± 3 12 ± 2  0.11 Omega6:3 fatty acids  0.1 ± 0.01  0.1 ± 0.03 0.006 Omega 9 fatty acids 101 ±33  72 ± 37 0.23 Total cis-unsaturated fatty 143 ± 99  207 ± 66  0.14acids Total trans-unsaturated fatty 10 ± 3  8 ± 2 0.16 acidsMonosaturated fatty acids 143 ± 46  111 ± 45  0.27 Polyunsaturated fattyacids 92 ± 27 96 ± 22 0.56

Table 4 provides blood based indicators of metabolic syndrome and fattyacid values for Group A dolphins of Example 1 during weeks 3, 6, 12, 18and 24 compared to baseline week 0. Significant P values are provided.

TABLE 4 Wild reference Blood variable dolphins Week 0 Week 3 Week 6 Week12 Week 18 Week 24 Serum fatty acids (%) Heptadecanoic acid 1.3 ± 0.40.3 ± 0.1 0.5 ± 0.2 0.5 ± 0.1 0.7 ± 0.3 0.8 ± 0.4 0.7 ± 0.2 (C17:0) P =P = P = P = P = 0.007 0.001 0.03 0.03 0.007 Arachidonic acid 17 ± 2  4 ±1 6 ± 2 7 ± 2 10 ± 4  10 ± 3  10 ± 3  (20:4n6) P = P = P = P = P = 0.0050.001 0.01 0.005 0.004 Behenic acid 0.7 ± 0.2 0.15 ± 0.04 0.21 ± 0.060.25 ± 0.07 0.28 ± 0.06 0.26 ± 0.04 0.29 ± 0.04 (C22:0) P = P = P = P =P < 0.004 0.0008 0.003 0.002 0.0001 Metabolic health indicators Insulin(μIU/ml) 2 ± 5 24 ± 21 17 ± 7  19 ± 23 22 ± 25 20 ± 21 16 ± 20 Insulin(μIU/ml)l 2 ± 5 19 ± 18 14 ± 5  10 ± 5  12 ± 9  11 ± 5  8 ± 2 [Plasmaglucose 102 ± 15 109 ± 21  103 ± 13  110 ± 14  109 ± 17  97 ± 12 95 ± 6 (mg/dl) Triglycerides 78 ± 26 132 ± 81  166 ± 67  112 ± 37  119 ± 30 117 ± 45  97 ± 28 (mg/dl) Iron (μm/dl) 109 ± 48  162 ± 64  153 ± 35  152± 52  160 ± 77  153 ± 31  177 ± 48  Iron (μg/dl)² 109 ± 48  132 ± 23 131 ± 4  127 ± 11  114 ± 38  136 ± 22  153 ± 29  Ferritin (ng/ml) 219 ±184 3697 ± 6813 4235 ± 8198 2954 ± 5271 1160 ± 1905 1218 ± 1695 2201 ±4656 Ferritin (ng/ml)² 219 ± 184 373 ± 52  341 ± 48  323 ± 52  263 ± 40 250 ± 67  243 ± 58  P = P = P = P = 0.0009 0.02 0.005 0.002 Transferrinsaturation 33 ± 11 50 ± 25 49 ± 17 50 ± 26 52 ± 33 51 ± 19 60 ± 22 (%)Transferrin saturation 33 ± 11 39 ± 5  40 ± 8  38 ± 8  31 ± 9  40 ± 7 49 ± 14 (%)² Ceruloplasmin 18 ± 6³  19 ± 5  18 ± 5  19 ± 4  23 ± 8  20 ±5  19 ± 5  (mg/dl) Haptoglobin (mg/dl) 17 ± 6³  11 ± 3  12 ± 5  12 ± 3 14 ± 6  14 ± 6  9 ± 9 ¹Results when removing dolphin with hightestosterone and breeding behavior during study. ²Two outlier highferritin dolphins, which also had decreasing ferritin during the feedingstudy, were removed to enable comparisons of mean values during thestudy. ³Based upon previously reported results on wild, free-rangingdolphins in the Indian River Lagoon (Mazzara LM, et al. (2012) Ironindices among bottlenose dolphins (Tursiops truncatus): identifyingpopulations at risk for iron overload. Comp Med 62: 508-515. PMID:23561885}

Table 5 provides targeted percent serum fatty acids and blood-basedmetabolic health indices in Group C dolphins (n=4) of Example 1,comparing values from weeks 12, 18 and 24 to baseline week 0. No valuesfrom weeks 12, 18, and 24 were significantly different than week 0.

TABLE 5 Blood variable Week 0 Week 12 Week 18 Week 24 Heptadecanoic acid(Cl 7:0) 0.30 ± 0.05 0.31 ± 0.07 0.29 ± 0.07 0.26 ± 0.04 Arachidonicacid (20:4n6) 5.2 ± 0.4 5.5 ± 0.8 6.0 ± 0.5 5.3 ± 0.7 Behenic acid(C22:0)  0.2 ± 0.02  0.2 ± 0.01  0.2 ± 0.04  0.2 ± 0.05 Glucose (mg/dl)103 ± 12  102 ± 28  108 ± 33  99 ± 14 Triglycerides (mg/dl) 49 ± 20 57 ±11 55 ± 15 91 ± 98 Ferritin (ng/ml) 503 ± 107 415 ± 93  384 ± 50  409 ±47 

Table 6 provides tested linear associations between Cl 7:0 and C20:4n6with ferritin in Group B dolphins (n=19) of Example 1 using a generallinear model.

TABLE 6 Association with Fatty acid serum ferritin (P value) Percentserum C17:0 0.22 Total serum C17:0 0.02 Percent RBC membrane C 17:0 0.14Total RBC membrane C 17:0 0.27 Percent serum C20:4n6 0.09 Total serumC20:4n6 0.03 Percent RBC membrane C20:4n6 0.16 Total RBC membraneC20:4n6 0.11

Analysis of FGF21, Ceramides, and Adiponectins

Aliquots of dolphin serum were shipped overnight on dry ice from thefeeding study population of six bottlenose dolphins in the U.S. NavyMarine Mammal Program (MMP). Upon arrival, the samples were flash thawedin a 40° C. water bath for 2 minutes, vortexed for 10 seconds, andcentrifuged at 3000×g for 10 seconds in tabletop centrifuge before beingaliquoted into 110 μl and 500 aliquots which were then frozen at −80° C.until tested.

Reagents used were ACS grade or better. Water, acetonitrile, andmethanol were LC-MS grade (Honeywell Burdick & Jackson, Morristown,N.J., USA). Synthetic stable isotope labeled peptides for adiponectinwere previously described in detail by Neely et al. (2013) (Neely etal., 2013) and were synthesized by New England Peptide (Gardner, Mass.,USA).

One microliter of diluted peptides (1:40; v/v, approximately 1 μg) wasloaded onto the trap at 50/min for 5 minutes before reverse phaseseparation at 350 nl/min from 0% to 40% mobile phase B [95% acetonitrilein 0.1% formic acid] over 50 minutes. Target proteotryptic peptides wereidentified by performing runs in positive ion information dependentacquisition mode with product ion scans for 50 ms with up to 20 production scans if precursors were 350-1250 m/z, exceeded 100 cps, and had a2+ to 5+ charge state. Raw data files generated by the AB Sciex 5600were converted to a peak list using the AB Sciex MS Data Converter (v.1.3. beta, June 2012). Protein identifications were made using MascotDaemon (v. 2.4.0) searching against the Ensembl (release 64) turTru 1dolphin genome assembly protein database [16,599 sequences; Lindblad-Toh(2011)] and the common Repository of Adventitious proteins database(cRAP; 2012.01.01; the Global Proteome Nlachine) using the followingparameters: trypsin was selected as the enzyme and two missed cleavageswere allowed; carbamidomethylation (Cys) was specified as a fixedmodification; Gln->pyro-Glu (N-term Q) and Oxidation (M) were specifiedas variable modifications; a peptide tolerance of 20 ppm and MS/MStolerance of 0.1 Da; instrument type was set to ESI-QUAD-TOF. Mascotfiles were then uploaded into Scaffold Q+(v.4.4.5) for analysis with aprotein threshold set to 1.0% false discovery rate (FDR), a minimumnumber of peptides set to 3, and a peptide threshold set to 50%.Proteins were excluded from analysis that did not have a spectral countgreater than 10 in at least one time point, or were missing more than 2values at a time point. The quantitative value was normalized to totalTIC with a normalization value set to 0. Exported values into sigma plot11.0 and log 10 transformed the data to help improve normality of thedata.

Measurement of FGF21

Serum FGF21 concentrations were determined using the Fibroblast GrowthFactor 21 Mouse/Rat ELISA kit (Biovendor, Asheville, N.C.). Samples werethawed on ice for one hour, vortexed, then diluted 1:4 in dilutionbuffer. Standards were prepared by reconstituting the dry FGF21 standardin 1 mL of dilution buffer to a final concentration of 2560 pg/mL FGF21.This standard solution was serially diluted 1:1 from 1280 to 20 pg/mLresulting in 7 standard solutions of: 1280, 640, 320, 160, 80, 40, and20 pg/mL. Samples at time 0 from animal A, W, and LL were pooled inorder to construct a standard reference material for estimation of batchvariability. A volume of sample, standard, or standard referencematerial equal to 100 μl was aliquoted in triplicate into the wells oftwo 96 well plates precoated with FGF21 antibody. Both samples andstandards were randomized in location on the two plates. Triplicatesamples from a single animal were always located on the same plate. Eachplate contained an independent series of standards and standardreference material. Plates were incubated at room temperature (20° C.)and shaken at 300 RPM for 1.6 hours. Plates were then washed three timeswith 35 μL of Wash Solution provided in the kit using a multi-channelpipette. Prior to and between washes the plates were inverted and tappeddry on a paper towel. Biotin Labelled Antibody solution (100 μL) wasadded to each well. Plates were further incubated at room temperature(20° C.) and shaken at 300 RPM for 1 hour. Plates were washed again asdescribed above. Streptavidin-HRP Conjugate solution (100 μL) was thenadded to each well. Plates were incubated at room temperature (20° C.)and shaken at 300 RPM for 30 minutes and washed as described above.Substrate solution (100 μL) was added to each well. The plates were thencovered with aluminum foil and incubated at room temperature (20° C.)for 20 minutes. Color development was stopped by adding 100 μL of StopSolution to each well. Plates were read on the Spectramax 340PC(Molecular Devices, Sunnyvale, Calif.) at 450 nm with a referencewavelength of 630 nm within 5 minutes of Stop Solution administration.Reference wavelength absorbance was subtracted from readings at 450 nmin order to obtain a final absorbance reading. A standard curve wascalculated by using a quadratic regression line between standardabsorbance's and known concentrations. Lower limit of detection (LLOD)was determined by adding 3× the standard deviation of the blank to themean of the blank. Lower limit of quantification (LLOQ) was determinedby adding 10× the standard deviation of the blank to the mean of theblank. Batch corrections were not applied as the coefficient ofvariation for the mean of the standard reference material was 0.23%.

Measurement of Ceramides

Serum aliquots (110 μl) were submitted to the MUSC Lipidomics Core forceramide and sphingosine determination following the establishedprotocol of (Bielawski et al., 2006). Briefly, serum was diluted inserum free media and spiked with internal standard solutions to quantifythe following: sphingosines (SPH), dihydro-sphingosines (dSPH),sphingosine-1-phosphates (S1P), dihydro-sphingosine-1-phosphates (dS1P),Ceramides (Cer 16:0, Cer 14:0, Cer 16:0, Cer 18:0, Cer 18:1, Cer 20:0,Cer 24:0, Cer 24:1, Cer 26:0, Cer 26:1), and dihydro-ceramide (Cerd16:0). The ceramides quantified contained a d18:1 sphingoid backboneand the numbers refer to the number of carbons:number of double bonds inthe N-linked fatty acid. Lipids were extracted using a solution of30:10:60 isopropanol:water:ethyl acetate. Samples were vortexed, andcentrifuged at 4000 rpm for 10 min. Supernatant was transferred to a newtube, formic acid was added, and the extraction process was repeated.Supernatants were then combined, evaporated and reconstituted in mobilephase A (1 mM ammonium formate in methanol containing 0.2% formic acid).This was vortexed and centrifuged for 5 min at 4000 rpm. The supernatantwas then injected into the HPLC system. Samples were analyzed on aTriple Quadrupole Mass Spectrometer equipped with Electrospray IonSource (Thermo Finnigan, PE Sciex) Concentrations were determined byexternal standard curve. Any sample that did not exceed theconcentration of the blank by a factor of two was considered below limitof detection. Data are reported as pmol/ml.

Measurement of Adiponectin

The preparation of serum for analysis of adiponectin was performedfollowing the established protocol of Neely et. al (2013) with thefollowing modifications. An aliquot of dolphin serum was thawed at roomtemperature for 1 minute, vortexed for 5 s, then diluted (1:10; v:v) in50 mM ammonium bicarbonate (AmBic). A solution of dithiothreitol(dissolved in 25 mN 1AmBic) was mixed by pipet to a final concentrationof 100 mM, then centrifuged briefly and incubated at 60° C. for 30 min.The reaction was allowed to cool for 5 min, then alkylated by theaddition of iodoacetamide (dissolved in 50 mM AmBic) to a finalconcentration of 10 mM and incubated at 37° C. for 30 minutes. Thereaction was diluted with 176.5 μl 50 mM AmBic before adding massspectrometry grade trypsin gold at a 1:10 ratio of enzyme to protein.The reaction was incubated at 37° C. for 16 hours then stopped by theaddition of 350 μl of 1% formic acid and incubated at room temperaturefor 30 minutes. The two isotopically labeled standards were added toeach sample, completed to 1 ml with 0.1% formic acid, and then loadedthe sample onto an acetonitrile conditioned Strata-X 33μ polymericreverse phase solid phase extraction column (Phenomenex, Torrance,Calif., USA). The column was washed twice with 1 ml 0.1% formic acid.Peptides were eluted first with 1 ml of 15% acetonitrile 0.1% formicacid then in a separate tube with 1 ml 30% acetonitrile 0.1% formicacid. Eluted samples were frozen at −80° C. overnight then dried downunder vacuum by speedvac. Each sample was resuspended in 100 μl MIPA(98% water, 2% acetonitrile, 0.1% formic acid), vortexed for 15 min,then centrifuged at 10,000×g for 5 minutes before being transferred to anew 1.5 ml microcentrifuge tube. Peptide concentration was estimated byAbsorbance at 280 nm (average 14 μg/μl). Prior to injection, 5 μl s ofthe sample was diluted into 1950 of MPA, and then injected onto the trapcolumn.

Peptides of total and Lys-75 unmodified adiponectin were quantifiedusing previously published protocols from Neely et. al (2013) with thefollowing modifications. Tryptic peptides (10 μl) were loaded onto a 100μm×2 cm C18 (100 A with 5 μm particles) trap column (Acclaim PepMap®100; Thermo Fisher Scientific) and separated on a 75 μm×15 cm C18 (100 Awith 3 μm particles) analytical column (Acclaim PepMap100®; ThermoFisher Scientific). Reverse phase separation occurred at 350 nl/min. ona 2D+ NanoLC Ultra system (Eksigent, Dublin, Calif., USA). The LC wasconnected via nanospray source to a Triple-TOP 5600 System (AB Sciex,Foster City, Calif., USA).

Dolphin sera were processed in randomized batches of 9. One serum ineach batch was processed in triplicate to determine experimentalvariability, plus a standard reference material (SRNI) serum to correctbetween experimental batches, and an experimental blank consisting ofphosphate buffered saline (PBS). The blank was processed identically toserums in each batch and digested with the same amount of trypsin as theSRM. For PRNI experiments, the instrument was set in positive ion modeand TOF-MS data were collected in a window of 450-1250 mls for 150 ms,followed by each parent ion MS/MS for 200 ms, from 100 to 1600 mls.Total dolphin adiponectin (IFY) was quantified by comparing the ratiobetween the native IFY y13²⁺ product ion (586.9³⁺->749.83²⁺m/z) and thecorresponding product ion from the SIS peptide (589.6³⁺->753.83²⁺m/z).The amount of Lys-75 unmodified (GDT) dolphin adiponectin was quantifiedby comparing the ratio between the native GDT y7+ product ion(716.34²⁺->715.37+m/z) and the corresponding product ion from thestandard peptide (721.34²⁺->725.37⁺m/z). The amount of % unmodified wascalculated as (GDT/IFY)×100.

Changes in Serum Concentrations

The levels of total and percent unmodified adiponectin in Group Adolphins was measured. The mean levels of adiponectin (pmol/mL±SD) forthe dolphins at 0-weeks was 776±401; 3-weeks, 937±531; 6-weeks, 806±382;12-weeks, 1147±477; 18-weeks, 1189±640; and 24-weeks 1196±467. Thechange in serum adiponectin levels were significantly elevated in thedolphins at weeks 12, 18, and 24 (P<0.002) compared to week 0 (FIG. 1C).The mean levels of percent unmodified adiponectin (mean % unmodified±SD)in the dolphins at week 0 was 23.8±6; 3-weeks, I 8.9±6; 6-weeks, 18.4±6;12-weeks, 18.0±4; 18-weeks, 16.0±4; 24-weeks, 15.2±5. The mean percentunmodified adiponectin was reduced (P<0.03) at all collection intervalsversus control at week 0 (FIG. 1D). One dolphin contained serum FGF21concentrations below the limit of quantification. In the other fivedolphin samples serum FGF21 concentrations ranged from 129-1599 pg/ml.The mean change in FGF21 levels were not significantly different overthe course of the study (FIG. 5).

Associations of Adiponectin with Metabolic Variables.

Serum adiponectin was positively associated with FGF21 (p=0.788,P<0.001) and heptadecanoic acid C 1 7:0 (p=0.441, P=0.008) andnegatively associated with ferritin (p=−0.425, P=0.011), transferrinsaturation (p=−0.381, P=0.024), and iron (p=−0.433, P=0.009) (Table 7).The amount of percent unmodified adiponectin was negatively correlatedwith total sphingosines (p=−0.434, P=0.009) and positively correlatedwith insulin (p=0.425, P=0.011) and ferritin (p=0.422, P=0.012) (Table7). FGF21 was negatively correlated with iron (p=−0.430, P=0.013) (Table7). Adiponectin and FGF21 were both negatively correlated with Cer 14:0,Cer 18:0, Cer 18:1, Cer 20:1, and Cer 22:1 (Table 7). No significantcorrelations were observed between the levels of serum adiponectin,percent unmodified adiponectin, or FGF21 with total ceramides, glucose,triglycerides, ceruloplasmin, and haptoglobin (Table 9).

Significant Changes in Ceramide Levels were Observed with a C 17:0-RichDiet.

Serum ceramide levels were measured in Group A dolphins at each timeinterval (FIG. 3; Table 10). Ceramide 24:1 was the most abundantceramide measured in the serum of the six dolphins comprising 40% onaverage of the total ceramides measured (Table 10). The levels of Cer24:1 were significantly reduced, 18% at week 6, 24% at week 12, 33% atweek 18, and 29% at week 24 compared to week 0 (FIG. 3E). Ceramide 18:1comprises about 2% of the total ceramides measured and was reduced 18%at week 3, 21% at week 6, 24% at week 12, 39% at week 18, and 27% atweek 24 compared to week 0 (FIG. 3A). Ceramide 20:1 comprisesapproximately 1% of the total ceramides measured and was reduced 21% atweek 3, 15% at week 6, 24% at week 12, 28% at week 18, and 31% at week24 compared to week 0 (FIG. 3C). The Cer d 16:0 composed approximately1% of the total ceramides and was significantly reduced approximately46% at week 18 compared to week 0 (Table 10). Ceramide 22:0 comprisedapproximately 7% of total ceramides and was significantly increased 96%at week 3, 59% at week 6, 69% at week 12, 44% at week 18, and 50% atweek 24 compared to week 0 (FIG. 3B). Ceramide 24:0 comprised roughly11% of total ceramides and was significantly increased 183% at week 3,98% at week 6, 129% at week 12, 66% at week 18, and 111%>at week 24compared to week 0 (FIG. 3D). Ceramide 26:0 comprised approximately 1%of total ceramides and was significantly increased 143% at week 3, 85%at week 6, 149% at week 12, 71% at week 18, and 111% at week 24 comparedto week 0 (FIG. 3F). No statistically significant change in serum levelsof Cer 14:0, Cer 16:0, Cer 18:0, Cer 20:0, Cer 22:1, and Cer 26:1, whichcomprised roughly 3%, 14%, 9%, 3%, 4%, and 5% of total serum ceramidesmeasured respectively, were observed compared to week 0 (Table 10).

Serum Sphingosine Levels Increased on a C17:0-Rich Diet.

Serum sphingosine levels were compared at each time point to week 0(FIG. 4 Table 10). Dihydrosphingosine was significantly elevated by 32%at 6 weeks (180 pmol/ml±24), 34% at 18 weeks (186 pmol/ml±30), and 45%at 24 weeks (199 pmol/ml±43) compared to week 0 (140 pmol/ml±27). Thelevels of dS1P were significantly elevated by 157% at week 24 (88pmol/ml±20) compared to week 0 (35 pmol/ml±5) (FIG. 4B). The mostabundant sphingosine measured was S1P which comprised approximately 49%of the total sphingosines and was significantly elevated by 92% at week24 (404 pmol/ml±59) compared to week 0 (211 pmol/ml±13) (FIG. 4C). Thelevels of total sphingosines (sum of sphingosines measured) weresignificantly increased by 21% at 6 weeks, 19% at 12 weeks, 24% at 18weeks, and 62% at 24 weeks after the change in diet (FIG. 4D). Totalceramides means were numerically lower, but were not found statisticallysignificant compared to time 0 (FIG. 4D). The change in serum levels ofSPH which comprised roughly 12% of the total sphingosines was notstatistically significant compared to week 0 (Table 10).

Significant Changes in Serum Proteins Identified by Mass Spectrometry

Mass spectrometry-based proteomics of undepleted serum led to theidentification of 59 proteins with a false discovery rate less than0.1%. Eight proteins were significantly different over the 24-week studyrelative to time 0 (Table 8). Corroborating the PRM/MS data, adiponectinwas significantly elevated by 2.66, 2.79, and 2.99-fold at weeks 12, 18,and 24 compared to week 0, respectively (Table 8). Haptoglobin waselevated by 1.72-fold at week 12 and 1.55-fold at week 18, compared toweek 0 (Table 8). Inter-alpha (globulin) inhibitor H3 displayed a1.51-fold increase only at week 12 compared to week 0 (Table 8). Serpinpeptidase inhibitor, Glade C-1 (Antithrombin III) was the only proteinsignificantly reduced, but this reduction was transient and only reducedat week 6 (−1.50-fold change) at week 6 compared to week 0 (Table 8).Although ANOVA identified Hemoglobin subunit beta, hemoglobin subunitalpha, apolipoprotein E, and albumin as significantly different,post-hoc analysis did not indicate statistical differences at any timepoint compared to week 0 (Table 8).

Table 7 provides Pearson product moment correlations (p) of Adiponectin,% Unmodified Adiponectin, and FGF21 with ceramides and blood laboratorymeasurements for Example 1.

TABLE 7 Measured Metabolic % Unmodified FGF21^(‡) P- VariablesAdiponectin^(†) (p) P-value Adiponectint (p) P-value (p) value Cer 14:0−0.375 0.026 0.018 0.921 −0.457 0.008 Cer d16:0 −0.099 0.569 0.380 0.024−0.001 0.997 Cer 18:0 −0.456 0.006 −0.439 0.008 −0.412 0.017 Cer 18:1−0.490 0.003 0.150 0.390 −0.384 0.027 Cer 20:0 −0.276 0.108 −0.495 0.002−0.179 0.319 Cer 20:1 −0.650 <0.001 −0.354 0.037 −0.522 0.002 Cer 22:1−0.615 <0.001 −0.029 0.867 −0.482 0.005 dSPH −0.089 0.609 −0.404 0.016−0.286 0.107 SIP 0.143 0.412 −0.391 0.020 −0.099 0.583 Total 0.075 0.669−0.434 0.009 −0.23 0.198 Sphingosines FGF21 0.788 <0.001 0.202 0.261 — —Venn-Watson et al. 2014 Values Insulin 0.120 0.493 0.425 0.010 0.0720.692 Iron −0.433 0.009 −0.053 0.763 −0.430 0.013 Transferrin −0.3810.024 −0.221 0.202 −0.344 0.050 saturation Ferritin −0.425 0.011 0.4220.012 −0.306 0.083 (C17:0) 0.441 0.008 0.778 0.657 0.218 0.223 ^(†)n =35; ^(‡)n = 33 Significance P < 0.05 are indicated in bold.

Table 8 shows fold change in quantitative spectral counts normalized tototal TIC for proteins identified in the serum of Group A dolphins ofExample 1.

TABLE 8 Fold Change from Week 0 RM-ANOVA 0 vs 0 vs 0 vs IdentifiedProteins Ensemble ID (P < 0.05) 0 vs 6 12 18 24 SERPINCl ENSTTRP- 0.033−1.50* −1.07 1.08 −1.22 (Antithrombin) 00000008123 Hemoglobin SubunitENSTTRP- 0.03 −1.34 1.84 1.58 1.17 Beta 00000016564 Haptoglobin ENSTTRP-0.041 1.02 1.72* 1.55* 1.02 00000001793 Hemoglobin Subunit ENSTTRP-0.048 −1.29 1.89 1.63 1.14 Alpha 00000011461 Apolipoprotein E ENSTTRP-0.041 −1.59 1.15 1.21 1.28 00000008256 Adiponectin NSTTRP- 0.001 1.932.66* 2.79* 2.99* 00000015964 Albumin ENSTTRP- 0.049 1.02 −1.03 −1.011.02 00000006225 Inter-Alpha (Globulin) ENSTTRP- 0.021 −1.73 1.51* 1.241.33 Inhibitor H3 00000002122 *= P < 0.05 for indicates a significantfold change using Holm-Sidak Post-hoc test for multiple comparisons tocontrol (week 0). Fold change was calculated using Non-transformed means

Table 9 provides Pearson product moment correlations (p) of Adiponectin,% Unmodified Adiponectin, and FGF21 with ceramides and blood laboratorymeasurements for Group A dolphins of Example 1.

TABLE 9 Adiponectin^(†) % Unmodified Sphingolipids (p) P-valueAdiponectin^(†) (p) P-value FGF2l^(‡) (p) P-value Cer 16:0 −0.221 0.2020.024 0.892 −0.260 0.144 Cer 22:0 −0.089 0.611 −0.251 0.146 −0.203 0.258Cer 24:0 0.092 0.598 −0.192 0.269 0.002 0.993 Cer 24:1 −0.263 0.1260.195 0.261 −0.124 0.493 Cer 26:0 0.053 0.763 −0.150 0.389 −0.059 0.746Cer 26:1 −0.027 0.879 0.222 0.724 0.045 0.804 Total Ceramides −0.2860.095 −0.005 0.979 −0.232 0.195 dhSlP 0.073 0.677 −0.284 0.099 −0.2030.256 SPH −0.022 0.901 −0.028 0.873 −0.206 0.251 Values from Venn-Watson et al. 2014 Glucose −0.059 0.735 −0.103 0.557 0.053 0.768Triglycerides −0.102 0.558 0.161 0.356 −0.097 0.590 Ceruloplasmin −0.3200.061 −0.164 0.348 −0.205 0.252 Haptoglobin 0.074 0.672 −0.079 0.651−0.062 0.731 ^(†)n-35; ^(‡)n-33

Table 10 provides a comprehensive list of Serum Ceramide and Sphingosineconcentrations for

Group A dolphins of Example 1, versus week 0.

TABLE 10 Serum Ceramides (pmols/ml ± SD) Week 0 Week 3 Week 6 Week 12Week 18 Week 24 Cer 14:0 76 ± 19 94 ± 34 85 ± 20 102 ± 38  74 ± 25 81 ±23 435 ± 142 562 ± 180 518 ± 151 454 ± 103 Cer 16:0 497 ± 112 398 ± 105Cer d16:0 70 ± 25 72 ± 49 49 ± 18 55 ± 23  36 ± 16^(†) 46 ± 15 Cer 18316 ± 78  316 ± 100 351 ± 84  363 ± 125 315 ± 63  276 ± 52  Cer 18:1 78± 17  60 ± 12^(†)  62 ± 12^(†)  58 ± 17^(†)  48 ± 14^(‡) 56 ± 9^(‡ ) Cer20:0 133 ± 50  113 ± 29  130 ± 38  126 ± 45  123 ± 38  106 ± 33  Cer20:1 40 ± 13  31 ± 10^(†) 33 ± 8*  30 ± 11^(†) 28 ± 9^(‡ ) 27 ± 9^(‡ )Cer 22:0 160 ± 50  259 ± 60^(‡ ) 237 ± 49^(† ) 255 ± 60^(‡ ) 215 ± 43*225 ± 42* Cer 22:1 167 ± 23  168 ± 48  170 ± 38  157 ± 39  134 ± 23  129± 35  Cer 24:0 187 ± 50   429 ± 171^(‡) 350 ± 66^(‡ )  409 ± 121^(‡) 290± 62^(† ) 378 ± 99^(‡ ) Cer 24:1 1826 ± 289  1567 ± 338  1485 ± 280 1383 ± 406* 1223 ± 227^(† ) 1287 ± 205^(‡ ) Cer 26:0 16 ± 5   33 ±12^(†) 27 ± 3*  36 ± 20^(†)  26 ± 11*  31 ± 14* Cer 26:1 186 ± 44  213 ±89  194 ± 76  194 ± 88  144 ± 43  171 ± 52  Total 3688 ± 672  3852 ±933  3734 ± 699  3685 ± 1016 3112 ± 558  3213 ± 522  Ceramides dSPH 140± 27  143 ± 20  180 ± 24* 149 ± 33  186 ± 30* 199 ± 43^(† ) dS1P 35 ± 5 35 ± 9  46 ± 14 53 ± 16 47 ± 11  88 ± 20^(‡) SPH 74 ± 22 60 ± 19 63 ± 2577 ± 43 61 ± 34 56 ± 7  S1P 211 ± 13  196 ± 19  266 ± 54  271 ± 50  275± 46  404 ± 59^(‡ ) Total Sphingosines 460 ± 39  434 ± 39  555 ± 86* 549± 69* 569 ± 64^(† )  747 ± 107^(‡) Significance was determined by arepeated measures one-way ANOVA with a Holm-Sidak post-hoc test. *=P <0.05, †= P < 0.01, and ‡= P < 0.001.

Example 2

Blood samples were taken from a managed population of thirty dolphinsfrom the Navy Marine Mammal Program (MMP). 2 h postprandial blood valuesfrom MMP dolphins with elevated insulin (Elevated insulin levels weredefined as values greater than or equal to the 75th quartile among the30 Group A dolphins (15 μIU/ml), n=8) were compared to MMP dolphinswithout elevated insulin (n=22). Table 11 illustrates values of elevatedversus non-elevated insulin. There were no differences in groups withregard to age (30±7 and 25±14 years, respectively; P=0.32) or sex(percent female 37.5% and 54.6%, respectively; P=0.68). Similar to whathas been previously reported with MMP dolphins, those with elevatedinsulin were also more likely to have higher glucose, triglycerides, andgamma-glutamyl transpeptidase (GGT) when compared to MMP dolphins withnon-elevated insulin, which can support the proposition that dolphinswith elevated insulin represent those with or at higher risk ofmetabolic syndrome.

TABLE 11 Elevated insulin Non-elevated insulin Metabolic variable (n =8) (n = 22) P value Metabolic panel Glucose (mg/dl) 114 ± 7  100 ± 8 0.002 Triglycerides (mg/dl) 164 ± 205 128 ± 43  0.007 Gamma-glutamyltranspeptidase (U/l) 33 ± 12 24 ± 10 0.046 Iron (μg/dl) 178 ± 39  177 ±63  0.64 Ferritin (ng/ml) 5,931 ± 4,210 3,131 ± 3,371 0.13 Transferrinsaturation (%) 53 ± 14 57 ± 21 1.0 HbA1c (%) 5.1 ± 0.2 5.2 ± 0.4 0.78Estimated average glucose (mg/dl) 85 ± 7  86 ± 12 0.78 Serum fatty acid(%) Heptadecanoic acid (C17:0) 1.0 ± 0.2 1.6 ± 0.3 0.0008 Oleic acid(C18:1n9) 21 ± 2  18 ± 4  0.03 Linoleic acid (C18:2n6) 1.6 ± 0.1 1.3 ±0.2 0.03 Arachidonic acid (C20:4n6)   3 ± 0.3 4 ± 1 0.004Eicosapentaenoic acid (C20:5n3) 10 ± 1  13 ± 3  0.006 Myristic acid(C14:0) 1.7 ± 0.4 1.9 ± 0.6 0.39 Palmitic acid (C16:0) 14 ± 1  14 ± 2 0.25 Palmitoleic acid (C16:1n7) 6 ± 1 6 ± 1 0.17 Stearic acid (C18:0) 12± 2  11 ± 2  0.66 Vaccenic acid (C18:1cis-lln7) 6 ± 2 6 ± 1 0.73a-Linolenic acid (C18:3n3) 0.2 ± 0.1 0.4 ± 0.7 0.28 Erucic acid(C22:1n9) 4.7 ± 1.7 4.6 ± 1.3 0.87 Docosatrienoic acid (C22:3n3) 0.1 ±0.1 0.1 ± 0.1 0.47 Docosapentaenoic acid (C22:5n3) 1.9 ± 0.1 2.0 ± 0.30.98 Docosahexaenoic acid (C22:6n3) 9.2 ± 0.9 8.9 ± 1.2 0.34 Tricosylicacid (C23:0) 0.5 ± 0.1 0.5 ± 0.3 0.32 Nervoic acid (C24:1n9) 1.0 ± 0.50.9 ± 0.4 0.76

From the data of Table 11, it can be seen that dolphins with elevatedinsulin also had higher oleic acid and linoleic acid; and lowerheptadecanoic acid, arachidonic acid, and EPA compared to non-elevatedinsulin dolphins. Thus, these five fatty acids, and margaric acid inparticular, can be employed as indicators of metabolic syndrome. See,e.g., Venn-Watson S. et al. (2015) Increased dietary intake of saturatedfatty acid heptadecanoic acid (C17:0) associated with decreasingferritin and alleviated metabolic syndrome in dolphins. PLOS ONE10:e0132117. The method by which the serum and red blood cell fatty acidprofiles was determined is described in Lagerstedt et al. “QuantitativeDetermination of Plasma C8-C26 Total Fatty Acids for the BiochemicalDiagnosis of Nutritional and Metabolic Disorders” Mol Gen Metabol73:38-45. This method for determining heptadecanoic acid can be used todirectly measure C17:0 (ug/ml) without having to measure all fatty acids(there are over fifty-five) and back calculating the percentage of C17:0. As such, this method can be much quicker, much more direct, and,much more cost effective than other methods conventionally used todetermine sera margaric acid levels.

FIGS. 8-11 are plots 10, 12, 14, and 16 of margaric acid (as apercentage of serum fatty acids in sera) versus 2 h postprandial insulin(μIU/ml), glucose (mg/dl), triglycerides (mg/dl) and ferritin (ng/ml),respectively, for the 30 MMP dolphins cited above. For each of therespective plots 10, 12, 14 and 16 in FIGS. 8-11, respective linearregressions 18, 20, 22 and 24 of the data were accomplished.

The statistical analyses depicted in FIGS. 8-11 were conducted using theWorld Programming System (World Programming Ltd., Hampshire, UnitedKingdom). Age, sex, and blood values (glucose, HbA1c, estimated averageblood glucose, triglycerides, GGT, iron, transferrin saturation,ferritin, and percent serum fatty acids) were compared between dolphinswith and without elevated insulin. Sex distribution was compared using aMantel-Haenzsel Chi-square test. Age and blood variable values werecompared using a Wilcoxon rank-sum test. For the five fatty acids thathad significant differences between dolphins with and without elevatedinsulin (heptadecanoic acid, oleic acid, linoleic acid, arachidonic acid(AA), and eicosapentaenoic acid (EPA)), simple linear and stepwisemultivariate regressions were used to test for associations betweenthese potential fatty acid predictors and dependent metabolic syndromeindices (insulin, glucose, triglycerides, and ferritin). In allanalyses, significance was defined as a P value less than 0.05.

From FIGS. 8-11, and using the above criteria, it can be seen that amongthe 30 MMP dolphins, percent serum heptadecanoic acid had negativelinear associations with insulin, glucose, triglycerides, and ferritin,respectively. Using the best fit, stepwise regression described above,it can be inferred from FIGS. 8-11 that heptadecanoic acid can be anindependent predictor of insulin (FIG. 8, P=0.0004), glucose (FIG. 9,P=0.0002) triglyceride (FIG. 10, P=0.0004), and ferritin (FIG. 11,P<0.0001) levels.

From the data above, it can be appreciated that there is a linearrelationship between levels of heptadecanoic acid and insulin, glucose,triglycerides and ferritin levels in sera for the MMP dolphins. Toconfirm this, the margaric acid levels of the sera in control populationB (Sarasota Bay dolphins) were checked.

FIG. 12 illustrates the results of the above heptadecanoic acid check.From FIG. 12, it can be seen that the control population of Sarasota Baydolphins had three times the level of heptadecanoic acid (measured as apercent serum fatty acid) than the case population A of MMP dolphins.Table 12 illustrates a comparison of the blood samples of theabove-cited 30 MMP dolphin versus the sera of 19 wild dolphins in theirnatural habitat (Sarasota Bay dolphins). MMP dolphins were older thanSarasota Bay dolphins mean age±SD=25.6±12.2 and 12.7±9.0 years,respectively; P=0.002). As shown in Table 12, M1YIP dolphins had higherinsulin, glucose, triglycerides, ferritin, iron, and transferrinsaturation compared to Sarasota Bay dolphins. MMP dolphins had lowerserum heptadecanoic acid when compared to Sarasota Bay dolphins. Whilered blood cell fatty acids were not collected on the initial group of 30MMP dolphins, this measurement was included for Sarasota Bay dolphins touse as a reference during the subsequent feeding study with MMPdolphins, as described more fully below.

TABLE 12 MMP Sarasota Bay Blood-based variable (n = 30) (n = 19) P valueMetabolic variable Total insulin (μIU/ml) 11 ± 12 2 ± 5 <0.0001 Glucose(mg/dl) 117 ± 10  104 ± 15  0.005 Triglycerides (mg/dl) 148 ± 59  78 ±26 <0.0001 Gamma-glutamyl transpeptidase 27 ± 11 20 ± 6  0.02 (U/L)Ferritin (ng/ml) 3,878 ± 3,754 219 ± 184 <0.0001 Iron (μg/dl) 177 ± 57 109 ± 48  <0.0001 Transferrin saturation (%) 56 ± 20 33 ± 11 <0.0001Targeted serum fatty acid (μg/ml) Heptadecanoic acid (C17:0) 9 ± 2 25 ±9  <0.0001

From the Table 12 data, it can be seen that among Sarasota Bay dolphins,serum heptadecanoic acid (μg/ml) was inversely associated with ferritin(R²=0.29 P=0.02). All Sarasota Bay dolphins with ferritin greater than219 ng/ml (this population's 50th quartile) had serum heptadecanoic acidlevels less than 25 μg/ml, suggesting that serum heptadecanoic acidlower than 25 μg/ml may result in an increased risk ofhyperferritinemia.

With a renewed focus on heptadecanoic acid, and referring now to FIG.13, comparisons of diets of MMP dolphins (Case Population A) with dietsof Sarasota Bay dolphins (Control Population B) were accomplished todetermine the levels of heptadecanoic acid in the food being eaten bythe two populations. As shown in FIG. 13, capelin, and the primary fishtype fed to MMP dolphins, had no detectable heptadecanoic acid comparedto other fish types. With the exception of squid (not shown in FIG. 13),capelin also had the lowest levels of iron compared to the other fishtypes. As shown in FIG. 13, mullet, and pinfish (which arerepresentative offish eaten by Sarasota Bay dolphins), had relativelyhigh levels of heptadecanoic acid. Mullet and pinfish also had thehighest iron levels among the fish tested. Due to the known presence ofheptadecanoic acid in dairy products, heptadecanoic acid levels weremeasured in off-the-shelf dairy products. Dairy products consumed byhuman are also shown in FIG. 13, for comparison. The content ofheptadecanoic acid (mg/100 g), from highest to lowest, was 42 (butter),31 (whole fat yogurt), 19 (whole fat milk), and 10 (2% fat milk).Heptadecanoic acid was not detected in either nonfat milk <2 mg/100 g ornonfat yogurt <10 mg/100 g.

From the above data, it can be seen that there is a linear relationshipbetween heptadecanoic acid and triglycerides, glucose, insulin andferritin in sera, which has been confirmed with measurements of bothheptadecanoic acid in dolphins for both a case population and a controlpopulation, as well as a measure of heptadecanoic acid in the dietseaten by the respective populations.

Building on the above results, a 24-week feeding study was accomplishedon the case population (MMP) dolphins, to determine if theabove-referenced triglycerides, glucose, insulin, and ferritin seralevels could be manipulated by manipulating the C 17:0 sera levels. Todo this, the diets of the case population MMP dolphins were manipulated.More specifically, the diets of six MMP dolphins were modified todecrease capelin and introduce pinfish or mullet (fish with an increasedamount of margaric acid) to their diet while maintaining the same dietcaloric intake. Stated differently, and as shown in FIG. 14, the averagedaily intake of heptadecanoic acid was increased from approximately 400mg to 1700 mg. The increase to 1700±500 mg daily heptadecanoic acid wasequal to an approximate minimum daily heptadecanoic acid intake of 3mg/lb body weight (6 mg/kg body weight). To evaluate potentialconfounding effects of the environment outside of the feeding study onthe dolphins, eight MMP dolphins, which were housed in the sameenvironment but not included in the feeding study, were monitored asreferences; these dolphins also had routine monthly blood samplescollected during months 0, 1, 3, 4, and 6.

FIGS. 15 and 16 are graphs of sera heptadecanoic acid (as a percentserum fatty acid and RBC in μg/ml, respectively) for the MMP dolphinsresulting from the above-described feeding study. Additionally, meanlevels of margaric acid in Sarasota Bay dolphins (indicated by lines 82and 92 in FIGS. 15-16) are included as a comparison. As can be seen inFIGS. 15-16, as a result of the increase in heptadecanoic acid intake,serum levels of heptadecanoic acid were higher in feeding study dolphinsduring weeks 3, 6, 12, 18, and 24 when compared to week 0.

To determine the effects of increased sera heptadecanoic acid depictedin FIGS. 15-16, the insulin in the feeding study dolphins was measured.The measurement results are depicted in FIG. 17. As shown in FIG. 17,the insulin levels of the feeding study dolphins decreased during theperiod of the feeding study, which confirms the effects of the increasedmargaric acid in the subject sera. In addition, and perhaps just asimportantly, a normalization of spread of insulin values for the subjectsera was observed from an initial spread illustrated by line 102 at thestart of the study (0 weeks) to a final spread 104 at 24 weeks.

To determine the effects of increased sera margaric acid depicted inFIGS. 15-16 on ferritin levels, and referring now to graphs 110 and 120in respective FIGS. 18 and 19, the ferritin in the feeding studydolphins was measured. As shown in FIGS. 18 and 19, serum ferritinlevels continually decreased in all six dolphins throughout the feedingstudy, with weeks 3 through 24 having lower levels than week 0.Excluding the two extremely high ferritin outliers depicted by lines 112and 114 in FIG. 17 (ferritin levels in the upper thousands to tens ofthousands); the remaining dolphins (represented by lines 122, 124, 126and 128 in FIG. 18) had the lowest mean serum ferritin (243±58 ng/ml) byweek 24. Moreover, the mean ferritin levels for these dolphinsapproached the Sarasota Bay dolphins' mean value of 219±184 ng/ml, asdepicted by line 130 in FIG. 19 (For purposes of the specification atherapeutic level can be defined as the mean level of Sarasota Baydolphins). Due to the dramatic decrease in serum ferritin in all sixfeeding study dolphins, indices of acute inflammation (ceruloplamsin andhaptoglobin) were assessed. Despite decreases in ferritin, there were nodifferences in these two proteins during any of the study weeks comparedto week 0, supporting a conclusion that the decreased ferritin was notdue to decreased acute inflammation.

In addition to the decrease in ferritin, and referring now to FIGS. 17,20 and 21, there was a distinct decrease in measures of spread forinsulin, glucose, and triglycerides that trended from weeks 0 to 24,i.e., there was a normalization of insulin, glucose and triglycerideslevel in subject sera. Changes in serum insulin, glucose, triglycerides,and ferritin during week 0 were compared to weeks 3, 6, 12, 18 and 24values were compared to week 0 using pairwise comparison t-tests (in thereference population, month 0 values were compared to months 1, 3, 4 and6). Given the apparent tightening or normalization of glucose,triglycerides, and insulin (5 of 6 dolphins) values among feeding studydolphins by week 24, measures of spread (standard deviation, SD, andcoefficient of variance, CV) were compared between weeks 0 and 24 forglucose, triglycerides, and insulin; outcomes were compared to thereference dolphin group. CV was calculated as follows: standarddeviation/mean).

With regard to decreasing measures of spread, the insulin standarddeviation (FIG. 17) decreased from about 50 to about 12 μIU/ml, whilethe standard deviation for glucose (FIG. 20) decreased fromapproximately 70 to 20 mg/dl. The standard deviation for triglycerides(FIG. 21) decreased from about 200 to 90 mg/dl. The coefficient ofvariation (C.V.) from week 0 to week 24 decreased from 22% to 6% forglucose and 61% to 24.% for triglycerides. When limiting to five studydolphins (excluding the outlier sixth dolphin), the insulin C.V.decreased from 100% to 38%. The decrease in measures of spread for thesethree key variables (normalization) is visually apparent from lines 102and 104 in FIG. 17, initial spread 132 and final spread 134 in FIG. 20,and respective initial and final spreads 142 and 144 in FIG. 21.

Among the reference dolphin group for the feeding study (dolphins whosediet was not modified), there was not a difference in serum ferritin(week 0=4,116±2,822 ng/ml) compared to weeks 3, 12, and 18 (4,433±3,000,4,055±2,534, and 3,418±2,059 ng/ml respectively; P=0.43, 0.92, and0.37). There were also no differences in glucose and triglycerides whencomparing week 0 with weeks 3, 12, and 18 (not shown); and the measuresof spread for glucose and triglycerides did not decrease from week 0 toweek 18 (standard deviation=16 and 15 mg/dl, C.V.=16% and 15% forglucose; and 58 and 48 mg/dl, C.V.=74% and 66% for triglycerides,respectively). Similarly, serum heptadecanoic acid (9.3±4 versus 9.3±4ng/dl; P=0.98) glucose, and triglycerides did not differ in mean ormeasures of spread for the reference population when comparing month 0with month 4.

While not statistically significantly different using the appliedmethods based upon the mean, mean levels of all three indicators ofmetabolic syndrome did trend down; for week 0 versus week 24, meaninsulin decreased from 24 to 16 μIU/ml, glucose from 105 to 95 mg/dl,and triglycerides from 132 to 87 mg/dl. In sum, FIGS. 17-21 can be takento mean that increased levels of heptadecanoic acid can result in adecrease of ferritin levels and a normalization of metabolic syndromebiomarkers in subject sera.

Heptadecanoic acid is an independent predictor among a full suite ofmetabolic syndrome indices, including glucose, insulin, triglycerides,and associated ferritin. When dolphins with hyperferritinemia increasedtheir dietary intake of heptadecanoic acid by changing fish types fed,ferritin, glucose, triglycerides, and insulin normalized by week 24.Because hyperferritinemia in humans is associated with metabolicsyndrome, and resolution of iron overload with phlebotomy improvesinsulin resistance, this suggests how heptadecanoic acid deficienciesmay be an underlying and treatable cause of hyperferritinemia andsubsequent metabolic syndrome in humans. This may be because bottlenosedolphins (Tursiops truncatus) and humans are large-brained, long livedspecies that develop similar diseases, including conditions associatedwith abnormal metabolism and aging. As such, dolphins have emerged asvaluable animal models relevant to human health.

Several parallels have been identified between dolphins and humans. Forexample, dolphins and humans are long-lived. The average lifespan ofdolphin is 20 years in the wild and 32 years at the MMP, with themaximum lifespan being approximately 60 years. Shared long lifespansbetween dolphins and humans are improving knowledge of chronic andaging-associated diseases in humans, including metabolic syndrome.Additionally, dolphins and humans have large brains. Among mammals,humans have the highest encephalization quotient (EQ=7.4), defined asthe actual versus expected brain size given a species' body size. Secondto humans is the bottlenose dolphin (EQ=5.3), higher than the chimpanzee(EQ=2.4) and much higher than the mouse (EQ=0.5). Similar to humans,positron emission tomography scans of living dolphins have revealed highlevels of glucose consumption by the dolphin brain. As such, sharedlarge brain size and associated high demand for glucose are likelydrivers for common glucose metabolism and associated conditions indolphins and humans.

In addition to the above, dolphins and humans have common pancreashistomorphology. The pancreas is responsible for production of insulin,a key hormone that regulates glucose metabolism. The microscopicstructure of the dolphin pancreas is a mix of both porcine (pig) andhuman. Specifically, pancreatic giant islets, originally believed to beunique to primates, are also present in the dolphin pancreas. Further,pancreatic islet cells increased in size with age, a phenomenon thatoccurs in aging people with type 2 diabetes. Finally, cetacean insulinis identical to porcine insulin, which is only one amino acid differentthan human insulin, demonstrating that cetacean, porcine, and humaninsulin are similar. Parallels between dolphins and humans related tothe pancreas support the dolphin's comparative value for human metabolicsyndrome and diabetes.

Dolphins and humans have similar glucose transport systems, as well ascommon genetic adaptations associated with glucose metabolism. Adultdolphins have a high capacity for red blood cell glucose transport usingthe GLUT-1 transporter isoform; previous to this discovery, thiscapability was thought to be limited to primates. Common red blood cellglucose transport systems in cetaceans and primates are believed to bedue to high central nervous system glucose demands. Also, the dolphingenome has been partially sequenced by Baylor University, based upon adolphin at the U.S. Navy Marine Mammal Program. Dolphins have geneticevolutionary adaptations that are unique to long-lived, large brainedspecies, including humans and elephants. Further, dolphins and humanshave similar genes responsible for glucose metabolism (Office of NavalResearch funded study, unpublished). Accordingly, Dolphins areappropriate models for human metabolic syndrome, diabetes,hyperferritinemia, and related conditions.

Dolphins and Humans Develop Similar Diseases and Disease Complications

Similar to humans, common bottlenose dolphins (Tursiops truncatus) candevelop subclinical metabolic syndrome, including elevated insulin,triglycerides, glucose, and ferritin, as well as fatty liver disease.Dolphins managed at the Navy Marine Mammal Program living in San DiegoBay, Calif., are a well-studied population with regard to metabolism,and this group has higher insulin, triglycerides, ferritin, and ironcompared to a wild bottlenose dolphin group living in Sarasota Bay, Fla.Importantly, the presence of case and reference populations of dolphinsfor metabolic syndrome parallel similar human population comparisons.

Similar to people, dolphins can develop nonalcoholic fatty liver disease(NAFLD). NAFLD has been found in both wild and managed collectiondolphins, supporting that dolphins have general physiologicsusceptibilities to metabolic syndrome. NAFLD is associated withmetabolic syndrome in both dolphins and humans, and progresses tohepatitis and cirrhosis. Progression of these metabolic perturbations inboth species is associated with insulin resistance and worsened glucosecontrol.

Similar to humans, dolphins can develop a chronic condition involvinghigh ferritin (hyperferritinemia) and iron. This disease in humans anddolphins involves excessive iron deposition primarily in the liver'sKupffer cells, progression with age, and associations with elevatedlipids, insulin, and liver enzymes. This metabolic state in dolphins isassociated with neither mutations in the HFE gene.

Dolphins develop similar age-associated blood changes as aging humans.Specifically, absolute lymphocytes, serum globulins, and mean plateletvolume increase linearly with increasing old age (=aging from 30 up to50 years old). Mean white blood cells, neutrophils, serum globulins,erythrocyte sedimentation rates, serum cholesterol, and serumtriglycerides; and the prevalence of neutrophilic leukocytosis,hyperglobulinemia, and hypercholesterolemia, were more likely to behigher as geriatric dolphins got older. This study demonstrated thatolder dolphins have changes in hematological and serum chemistry valuessimilar to those found in older humans. As such, bottlenose dolphins canserve as a useful comparative model for aging in humans.

Dolphins and humans have a common evolutionary driver for insulinresistance. An increasingly accepted theory is that insulin resistancein humans evolved in ancestral primates during the last ice age. Duringthis time, our ancestors changed from a high carbohydrate, low proteindiet to a low carbohydrate, high protein diet. This change enabledgenetic selection of insulin resistance to help maintain blood sugarlevels needed for large brains. When humans returned to increasinglyhigh carbohydrate diets, however, insulin resistance became a pathologiccondition and led to type 2 diabetes. Approximately fifty-five millionyears ago, the dolphin was a terrestrial mammal that evolved to livecompletely in the marine environment. The closest terrestrial relativesof dolphins are artiodactyls, including cows, pigs, and camels. Most ofthese relatives are strict herbivores, and none are strict carnivores.As such, it may be assumed that the terrestrial ancestor of dolphins atea high carbohydrate, low protein diet. Similar to the evolutionary pathof humans during the ice age, dolphins changed to a high protein, lowcarbohydrate diet when they moved to the ocean. Because dolphins, too,have developed large brains with high demands for readily availableglucose, they may have also selected for insulin resistance to maintainhigh blood glucose levels.

For the above reasons, dolphins and humans share important common groundrelated to anatomy, physiology, and disease states that support thedolphin as an important and relevant animal model for human diseases,including metabolic syndrome and hyperferritinemia. The results citedherein for dolphins can also be beneficial for humans.

Heptadecanoic acid (C17:0), also called margaric acid, is a saturatedfatty acid present in bovine milk fat and was the original component ofmargarine (hence, margarine's name) in the late 1800s. Heptadecanoicacid in margarine, however, was replaced with less costly and morereadily available plant-based and trans-fatty acids. When off the shelfdairy products were tested in the current study, heptadecanoic acid washighest in butter and whole fat yogurt and absent in nonfat dairyproducts. Interestingly, despite consumer's movement away from high fatfoods, dairy consumption in humans has been associated with multiplehealth benefits, including lower risks of insulin resistance syndrome,metabolic syndrome, and type 2 diabetes. To date, the mechanism of thebenefits of dairy products on human metabolism has not been determined.Based upon the results using the methods of the embodiments, it can beproposed that heptadecanoic acid may be a key player in the metabolicbenefits of dairy products in humans.

To take advantage of these benefits, heptadecanoic acid can be used inacid in a supplement, food additive, food fortifier, beverage additive,beverage fortifier, or pharmaceutical in any form, including as atablet, encapsulated pill, gelcap pill, liquid suspension, spray, andpowder. Additionally, diagnostic tests and assays for heptadecanoic acidin human and animal samples (including blood (serum, plasma, anderythrocyte membranes), urine, and feces) can be used to detect lowheptadecanoic acid levels and to continually monitor heptadecanoic acidlevels in patients. The use of heptadecanoic acid can prevent, stem, andtreat: 1) Elevated ferritin and associated complications, including ironoverload, metabolic syndrome, type 2 diabetes, autoimmune diseases, andneurodegenerative diseases (including but not limited to Alzheimer'sdisease, Parkinson's disease, and restless leg syndrome); and, 2)Metabolic syndrome components and associated complications, includingdyslipidemia, hypertriglyceridemia, elevated glucose, elevated insulin,type 2 diabetes, heart disease, and stroke. These egregious healtheffects can be prevented not only in dolphins, but because of thesimilarities in blood panels, they can be prevented in human mammals aswell.

Referring now to FIG. 22, scatter plots of heptadecanoic acid versusinsulin for both the control populations and the study populations isshown. As shown in FIG. 22, using a proposed therapeutic threshold ofserum heptadecanoic of 0.4 percent as percent of the total fatty acid inserums, can maintain a low insulin (as defined above) level.

It is unknown precisely how high ferritin increases the risk ofdiabetes, but proposed mechanisms include direct injury to the liver andpancreas from excessive deposition or indirect injury from increasedoxidative radicals. Currently, the most accepted means of treatinghyperferritinemia and associated iron overload in humans is phlebotomy(removal of iron in the blood). The methods according to severalembodiments describe methods wherein hyperferritinemia that isassociated with prediabetes can be reversible using a modified diet mostlikely involving increased dietary intake of heptadecanoic acid.Reversal of hyperferritinemia by week 3 using the modified diet wasfollowed by normalization of prediabetes/metabolic syndrome (normalizedglucose, insulin, and triglycerides) at week 24, as described above. Infact, the methods of the embodiments can be used to treathyperferritinemia with requiring phlebotomy.

Referring now to FIG. 23, scatter plots of heptadecanoic acid versusferritin levels for both the control populations and the studypopulations is shown. As shown in FIG. 23, using a proposed therapeuticthreshold of serum heptadecanoic of 0.4 percent as percent of the totalfatty acid in serums, can also maintain a therapeutic ferritin (asdefined above) level.

Study dolphins from MMP and Sarasota Bay live in the open ocean, andknown dietary intake was limited to fish fed to MMP dolphins. MMPdolphins live in netted enclosures in San Diego Bay, and changingpopulations of local fish are readily available to eat. While MMPdolphins can eat local fish, however, observation of feeding behaviorsby MMP's animal care staff and maintained dolphin appetites for fed fishsupport that the majority of dietary fish are those that are fed by theMMP. Reference dolphins in the same population and environment, however,did not have the same decreases in serum ferritin and normalization ofglucose and triglycerides. The data suggest a direct effect forheptadecanoic acid on lowering high serum ferritin in the feeding studyinvolved fish with higher heptadecanoic acid. The potential impact (orcumulative impacts) of other nutrients in the modified diet on serumferritin has not been determined. Identification of 1) higher serumpercent heptadecanoic acid as an independent predictor of lower serumferritin, 2) demonstrated increased dietary intake and percent serumheptadecanoic acid during the feeding study, and 3) coincident decreasesin serum ferritin and increases in percent serum heptadecanoic acid byweek 3, provide evidence that increasing dietary heptadecanoic acidcontributed to decreased serum ferritin, which indicates thatheptadecanoic acid can be used to treat hyperferritinemia, metabolicsyndrome, and diabetes, as well as other associated or relatedconditions.

Heptadecanoic acid deficiencies can be used to detect a risk of or causefor metabolic syndrome and associated hyperferritinemia. Dietarysupplementation with heptadecanoic acid can help resolve bothconditions, as well as type 2 diabetes. Further, givenhyperferritinemia's association with autoimmunity in humans, the use ofheptadecanoic acid deficiency detection and resolution as a means toprevent or manage disease can apply to type 1 diabetes, as well as otherautoimmune diseases.

The following materials are incorporated herein by reference in theentirety: Colegrove K. et al. (2015) Histomorphology of the bottlenosedolphin (Tursiops truncatus) pancreas and association of increasingislet f3-cell size with chronic hypercholesterolemia. J Gen CompEndocrinol 14:17-23; Venn-Watson S. et al. (2012) Hemochromatosis andfatty change: building evidence for insulin resistance in bottlenosedolphins (Tursiops truncatus). J Zoo Wildlf Med 43:S35-S47; Venn-WatsonS. et al. (2007) Big brains and blood glucose: Common ground fordiabetes mellitus in humans and healthy dolphins. Comp Med 57:390-5;Venn-Watson S. et al. (2013) Blood-Based Indicators of InsulinResistance and Metabolic Syndrome in Bottlenose Dolphins (Tursiopstruncatus). Front Endocrinol (Lausanne) 4:136; Venn-Watson S. et al.(2011) Dolphins as animal models for type 2 diabetes: Sustained,postprandial hyperglycemia and hyperinsulinemia. Gen Comp Endocrin170:193-9; Venn-Watson S. et al. (2014) Dolphins and Diabetes: ApplyingOne Health for breakthrough discoveries. Front Endocrinol DOI10.3389/fendo.2014.00227; Venn-Watson S. et al. (2015) Increased dietaryintake of saturated fatty acid heptadecanoic acid (C17:0) associatedwith decreasing ferritin and alleviated metabolic syndrome in dolphins.PLOS ONE 10:e0132117.

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The above description presents the best mode contemplated for carryingout the present invention, and of the manner and process of making andusing it, in such full, clear, concise, and exact terms as to enable anyperson skilled in the art to which it pertains to make and use thisinvention. This invention is, however, susceptible to modifications andalternate constructions from that discussed above that are fullyequivalent. Consequently, this invention is not limited to theparticular embodiments disclosed. On the contrary, this invention coversall modifications and alternate constructions coming within the spiritand scope of the invention as generally expressed by the followingclaims, which particularly point out and distinctly claim the subjectmatter of the invention. While the disclosure has been illustrated anddescribed in detail in the drawings and foregoing description, suchillustration and description are to be considered illustrative orexemplary and not restrictive.

All references cited herein are incorporated herein by reference intheir entirety. To the extent publications and patents or patentapplications incorporated by reference contradict the disclosurecontained in the specification, the specification Is intended tosupersede and/or take precedence over any such contradictory material.

Unless otherwise defined, all terms (including technical and scientificterms) are to be given their ordinary and customary meaning to a personof ordinary skill in the art, and are not to be limited to a special orcustomized meaning unless expressly so defined herein. It should benoted that the use of particular terminology when describing certainfeatures or aspects of the disclosure should not be taken to imply thatthe terminology is being re-defined herein to be restricted to includeany specific characteristics of the features or aspects of thedisclosure with which that terminology is associated. Terms and phrasesused in this application, and variations thereof, especially in theappended claims, unless otherwise expressly stated, should be construedas open ended as opposed to limiting. As examples of the foregoing, theterm ‘including’ should be read to mean ‘including, without limitation,’‘including but not limited to,’ or the like; the term ‘comprising’ asused herein is synonymous with ‘including,’ ‘containing,’ or‘characterized by,’ and is inclusive or open-ended and does not excludeadditional, unrecited elements or method steps; the term ‘having’ shouldbe interpreted as ‘having at least;’ the term ‘includes’ should beinterpreted as ‘includes but is not limited to;’ the term ‘example’ isused to provide exemplary instances of the item in discussion, not anexhaustive or limiting list thereof; adjectives such as ‘known’,‘normal’, ‘standard’, and terms of similar meaning should not beconstrued as limiting the item described to a given time period or to anitem available as of a given time, but instead should be read toencompass known, normal, or standard technologies that may be availableor known now or at any time in the future; and use of terms like‘preferably,’ ‘preferred,’ ‘desired,’ or ‘desirable,’ and words ofsimilar meaning should not be understood as implying that certainfeatures are critical, essential, or even important to the structure orfunction of the invention, but instead as merely intended to highlightalternative or additional features that may or may not be utilized in aparticular embodiment of the invention. Likewise, a group of itemslinked with the conjunction ‘and’ should not be read as requiring thateach and every one of those items be present in the grouping, but rathershould be read as ‘and/or’ unless expressly stated otherwise. Similarly,a group of items linked with the conjunction ‘or’ should not be read asrequiring mutual exclusivity among that group, but rather should be readas ‘and/or’ unless expressly stated otherwise.

Where a range of values is provided, it is understood that the upper andlower limit, and each intervening value between the upper and lowerlimit of the range is encompassed within the embodiments.

With respect to the use of substantially any plural and/or singularterms herein, those having skill in the art can translate from theplural to the singular and/or from the singular to the plural as isappropriate to the context and/or application. The varioussingular/plural permutations may be expressly set forth herein for sakeof clarity. The indefinite article ‘a’ or ‘an’ does not exclude aplurality. A single processor or other unit may fulfill the functions ofseveral items recited in the claims. The mere fact that certain measuresare recited in mutually different dependent claims does not indicatethat a combination of these measures cannot be used to advantage. Anyreference signs in the claims should not be construed as limiting thescope.

It will be further understood by those within the art that if a specificnumber of an introduced claim recitation is intended, such an intentwill be explicitly recited in the claim, and in the absence of suchrecitation no such intent is present. For example, as an aid tounderstanding, the following appended claims may contain usage of theintroductory phrases ‘at least one’ and “one or more” to introduce claimrecitations. However, the use of such phrases should not be construed toimply that the introduction of a claim recitation by the indefinitearticles ‘a’ or ‘an’ limits any particular claim containing suchintroduced claim recitation to embodiments containing only one suchrecitation, even when the same claim includes the introductory phrases‘one or more’ or ‘at least one’ and indefinite articles such as ‘a’ or‘an’ (e.g., ‘a’ and/or ‘an’ should typically be interpreted to mean ‘atleast one’ or ‘one or more’); the same holds true for the use ofdefinite articles used to introduce claim recitations. In addition, evenif a specific number of an introduced claim recitation is explicitlyrecited, those skilled in the art will recognize that such recitationshould typically be interpreted to mean at least the recited number(e.g., the bare recitation of ‘two recitations,’ without othermodifiers, typically means at least two recitations, or two or morerecitations). Furthermore, in those instances where a conventionanalogous to ‘at least one of A, B, and C, etc.’ is used, in generalsuch a construction is intended in the sense one having skill in the artwould understand the convention (e.g., ‘a system having at least one ofA, B, and C’ would include but not be limited to systems that have Aalone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). In those instances where aconvention analogous to ‘at least one of A, B, or C, etc.’ is used, ingeneral such a construction is intended in the sense one having skill inthe art would understand the convention (e.g., ‘a system having at leastone of A, B, or C’ would include but not be limited to systems that haveA alone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). It will be furtherunderstood by those within the art that virtually any disjunctive wordand/or phrase presenting two or more alternative terms, whether in thedescription, claims, or drawings, should be understood to contemplatethe possibilities of including one of the terms, either of the terms, orboth terms. For example, the phrase ‘A or B’ will be understood toinclude the possibilities of ‘A’ or ‘B’ or ‘A and B.’

All numbers expressing quantities of ingredients, reaction conditions,and so forth used in the specification are to be understood as beingmodified in all instances by the term ‘about.’ Accordingly, unlessindicated to the contrary, the numerical parameters set forth herein areapproximations that may vary depending upon the desired propertiessought to be obtained. At the very least, and not as an attempt to limitthe application of the doctrine of equivalents to the scope of anyclaims in any application claiming priority to the present application,each numerical parameter should be construed in light of the number ofsignificant digits and ordinary rounding approaches.

Furthermore, although the foregoing has been described in some detail byway of illustrations and examples for purposes of clarity andunderstanding, it is apparent to those skilled in the art that certainchanges and modifications may be practiced. Therefore, the descriptionand examples should not be construed as limiting the scope of theinvention to the specific embodiments and examples described herein, butrather to also cover all modification and alternatives coming with thetrue scope and spirit of the invention.

What is claimed is:
 1. A pharmaceutical composition comprising: one ormore odd chain fatty acids or pharmaceutically acceptable salts thereof;a pharmaceutically acceptable carrier; wherein at least one of the oneor more odd chain fatty acids is selected from the group consisting ofC15:0 (pentadecanoic acid) and C17:0 (heptadecanoic acid); and, whereinthe composition is in a unit dosage for the treatment of conditionsselected from the group consisting of type 2 diabetes, elevated fastingplasma glucose, elevated serum triglycerides, and hyperferritinemia. 2.The pharmaceutical composition of claim 1, wherein the composition issubstantially free from even chain fatty acids.
 3. The pharmaceuticalcomposition of claim 1, configured for administration of from 2.5 mg to11 mg, per 1 kg of body weight, of the one or more odd chain fatty acidsor pharmaceutically acceptable salts thereof to a patient.
 4. Thepharmaceutical composition of claim 3, configured for administrationonce per day.
 5. The pharmaceutical composition of claim 1, comprisingfrom 0.01 mg to 10000 mg of the one or more odd chain fatty acids orpharmaceutically acceptable salts thereof.
 6. The pharmaceuticalcomposition of claim 1, wherein said pharmaceutical composition is usedin the manufacture of a medicament for treatment or prophylaxis ofconditions selected from the group consisting of type 2 diabetes,elevated fasting plasma glucose, elevated serum triglycerides, andhyperferritinemia.
 7. The pharmaceutical composition of claim 1, whereinthe odd chain fatty acid is C15:0 (pentadecanoic acid).
 8. Thepharmaceutical composition of claim 1, wherein the odd chain fatty acidis C17:0 (heptadecanoic acid).